Clinical presentations and hematological alterations in malaria patients and their association with plasmodium species and disease severity at Ghambat Institute of Medical Sciences
DOI:
https://doi.org/10.61529/idjp.v35i1.504Abstract
Objective: To identify the prevalence of the clinical manifestations and changes in the hematological parameters of patients with malaria and to study their correlation with the various Plasmodium species to identify species-specific trends associated with severity of disease.
Material and Methods: The study is a descriptive cross-sectional study, which was carried out at the Department of General Medicine, Ghambat Institute of Medical Sciences, from 17th July 2025-17th January 2026. Consecutive sampling was used to enroll 162 patients aged between 18 and 70 years with malaria confirmed by peripheral blood smear. Hematological parameters and clinical characteristics were compared between different species of malaria.
Results: A total of 151 patients with confirmed malaria were included (mean age 32.6 ± 14.1 years; 46.1% males). Plasmodium vivax was the most common species (60.3%), followed by P. falciparum (39.7%). All patients presented with fever with rigors/chills, while headache (81.5%) and nausea/vomiting (75.9%) were the most frequent accompanying symptoms. Thrombocytopenia (79.0%), anemia (57.4%), and high RDW (52.5%) were the most common hematological abnormalities. Anemia and low MCV were more frequently observed in P. falciparum infections and among males, whereas low MCHC was more common in females.
Conclusion: The most common haematological changes in malaria patients are thrombocytopenia and anemia, and the presence of fever, headache, and nausea/vomiting is the most frequent presentation of the illness, especially Plasmodium vivax, which underscores the need to identify it at early stages and then treat the illness.
Keywords: Anemia, Haematological changes, Malaria, Plasmodium vivax, Thrombocytopenia
References
Khuraiya P, Sharma SS, Thakur AS, Pandey VP, Verma S. The study of clinical, biochemical and hematological profile in malaria patients. Int J Adv Med. 2016;3(2):209–17. DOI: https://doi.org/10.18203/2349-3933.ijam20160685
World Health Organization. WHO Malaria Policy Advisory Group (MPAG) meeting: October 2022. Geneva: World Health Organization; 2022. Available from: https://www.who.int/publications/i/item/9789240063303
World Health Organization. Update on the E-2020 initiative of 21 malaria-eliminating countries: report and country briefs. Geneva: World Health Organization; 2018. Available from: https://www.who.int/publications/i/item/WHO-CDS-GMP-2018.10
Plewes K, Turner GD, Dondorp AM. Pathophysiology, clinical presentation, and treatment of coma and acute kidney injury complicating falciparum malaria. Curr Opin Infect Dis. 2018; 31(1): 69–77. DOI: https://doi.org/10.1097/QCO.0000000000000419
Wahlgren M, Goel S, Akhouri RR. Variant surface antigens of Plasmodium falciparum and their roles in severe malaria. Nat Rev Microbiol. 2017; 15(8): 479–91. DOI: https://doi.org/10.1038/nrmicro.2017.47
Yam, XY, Niang M, Madnani KG, Preiser PR. Three is a crowd - New insights into rosetting in Plasmodium falciparum. Trends Parasitol. 2017; 33(4): 309–20. DOI: https://doi.org/10.1016/j.pt.2016.12.012
Naser RH, Rajaii T, Farash BR, Seyyedtabaei SJ, Hajali V, Sadabadi F, et al. Hematological changes due to malaria: an update. Mol Biochem Parasitol. 2024; 259: 111635.
DOI: https://doi.org/10.1016/j.molbiopara.2024.111635
Punnath K, Dayanand KK, Chandrashekar VN, Achur RN, Kakkilaya SB, Ghosh SK, et al. Clinical features and haematological parameters among malaria patients in Mangaluru city area in the southwestern coastal region of India. Parasitol Res. 2020; 119(3): 1043–56. DOI: https://doi.org/10.1007/s00436-019-06540-2
Morang’a CM, Amenga-Etego L, Bah SY, Appiah V, Amuzu DS, Amoako N, et al. Machine learning approaches classify clinical malaria outcomes based on haematological parameters. BMC Med. 2020; 18(1): 375. DOI: https://doi.org/10.1186/s12916-020-01823-3
White NJ. Anaemia and malaria. Malar J. 2018; 17(1): 371. DOI: https://doi.org/10.1186/s12936-018-2509-9
Al-Saadi EA, Abdulnabi MA. Hematological changes associated with COVID-19 infection. J Clin Lab Anal. 2022; 36(1): e24064.
DOI: https://doi.org/10.1002/jcla.24064
Awoke N, Arota A. Profiles of hematological parameters in Plasmodium falciparum and Plasmodium vivax malaria patients attending Tercha General Hospital, Dawuro Zone, South Ethiopia. Infect Drug Resist. 2019; 12: 521–7.
DOI: https://doi.org/10.2147/IDR.S184489
Asmerom H, Gemechu K, Sileshi B, Arkew M. Hematological abnormalities among malaria-infected adult patients in association with ABO blood groups at Jinella Health Center, Harar, Eastern Ethiopia. J Blood Med. 2023; 14: 463–76.
DOI: https://doi.org/10.2147/JBM.S419815
Khan M, Nisar H, Mushahid N. Clinical and lab profile of severe and uncomplicated malaria: a prospective study from Khuzdar, Balochistan. Pak J Med Sci. 2021; 37(7): 1918–23. DOI: https://doi.org/10.12669/pjms.37.7.4210
Zafar S, Khan RSA., Jaffri AR, Zaidi SAR, Karim MN, Shaukat M. Clinical and hematological criteria for malaria diagnosis in endemic area with limited resources. Pak Armed Forces Med J. 2025; 75(SUPPL-5): S701-S705. DOI: https://doi.org/10.51253/pafmj.v75iSUPPL-5.8334
Kotepui M, Ratcha C, Uthaisar K. Clinical characteristics, parasite diagnosis and hematological parameters of malaria in Surat Thani Province, Thailand. J Health Res. 2017; 31(4): 281–9.
DOI:https://he01.tcithaijo.org/index.php/jhealthres/article/view/92159
Groger M, Fischer HS, Veletzky L, Lalremruata A, Ramharter M. A systematic review of the clinical presentation, treatment and relapse characteristics of human Plasmodium ovale malaria. Malar J. 2017; 16(1): 112. DOI: https://doi.org/10.1186/s12936-017-1759-2
Chaloemwong J, Tantiworawit A, Rattanathammethee T, Hantrakool S, Chai-Adisaksopha C, Rattarittamrong E, et al. Useful clinical features and hematological parameters for the diagnosis of dengue infection in patients with acute febrile illness: a retrospective study. BMC Hematol. 2018; 18(1): 20. DOI: https://doi.org/10.1186/s12878-018-0116-1
Hunt L, Gupta-Wright A, Simms V, Tamba F, Knott V, Tamba K, et al. Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study. Lancet Infect Dis. 2015; 15(11): 1292–9. DOI: https://doi.org/10.1016/S1473-3099(15)00144-9
Varo R, Balanza N, Mayor A, Bassat Q. Diagnosis of clinical malaria in endemic settings. Expert Rev Anti-infective Therapy. 2021; 19(1): 79–92. DOI; https://doi.org/10.1080/14787210.2020.1807940
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Copyright (c) 2026 Dr. Zeeshan Ahmed, Dr. Bakht Ali, Dr. Khalida Parveen, Zarnain Riaz, Dr. Waheed Abid, Dr. Aftab Hussain Shah
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