Correlation between Thrombocytopenia and Anaemia in Plasmodium falciparum malaria among patients in Kisumu County-Western Kenya

Background: Malaria is associated with haematological complications which may be avoided by early diagnosis and treatment. Microscopic diagnosis showing presence of malarial parasites is needed for confirmation which requires technical expertise. The study was therefore carried out determine the correlation between thrombocytopenia and anaemia in P.falciparum malaria.Methods: The study was conducted in Kisumu County-Kenya which is a highly endemic malaria region. Both thick and thin blood smears were used to determine P. falciparum infection status in a total of 228 patients presenting with acute febrile illness. All participants’ demographics and Haematological parameters i.e. Haemoglobin level, platelet count, Mean platelet volume and platelet distribution width were analysed.Results: Haemoglobin and platelet count were significantly lower in the malaria infected group (p<0.001 in both cases). Conversely, mean platelet volume and platelet distribution width were higher in comparison to non-infected group (p<0.001). Severe to moderate anaemia was present in 78 %( n=122) of malaria infected patients against 47 %( n=33) of the non-infected group. Thrombocytopenia was present in 87 %( n=137) of the infected patients against 10 % (n=7) of the non-infected group. There was a positive correlation between anaemia and thrombocytopenia in malaria(r= 0.26, p<0.001). Conclusion: Low platelet count and Haemoglobin levels positively correlate and are important predictors of P .falciparum malaria. This could to avoid performing unnecessary expensive tests to rule out other febrile conditions. The above findings also have therapeutic implications of avoiding unnecessary platelet infusion in malaria. Keywords: thrombocytopenia, pseudo-thrombocytopenia, anaemia and haemoglobin.Afr J Health Sci. 2016; 29(2):76-8

Recurrent plasmodium falciparum malaria infections in kenyan children diminish t-cell immunity to epstein barr virus lytic but not latent antigens

Plasmodium falciparum malaria (Pf-malaria) and Epstein Barr Virus (EBV) infections coexist in children at risk for endemic Burkitt's lymphoma (eBL); yet studies have only glimpsed the cumulative effect of Pf-malaria on EBV-specific immunity. Using pooled EBV lytic and latent CD8+ T-cell epitope-peptides, IFN-γ ELISPOT responses were surveyed three times among children (10 months to 15 years) in Kenya from 2002–2004. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated in association with Pf-malaria exposure, defined at the district-level (Kisumu: holoendemic; Nandi: hypoendemic) and the individual-level. We observed a 46% decrease in positive EBV lytic antigen IFN-γ responses among 5–9 year olds residing in Kisumu compared to Nandi (PR: 0.54; 95% CI: 0.30–0.99). Individual-level analysis in Kisumu revealed further impairment of EBV lytic antigen responses among 5–9 year olds consistently infected with Pf-malaria compared to those never infected. There were no observed district- or individual-level differences between Pf-malaria exposure and EBV latent antigen IFN-γ response. The gradual decrease of EBV lytic antigen but not latent antigen IFN-γ responses after primary infection suggests a specific loss in immunological control over the lytic cycle in children residing in malaria holoendemic areas, further refining our understanding of eBL etiology