THROMBOCYTOPENIA AND ELEVATED ALANINE AMINOTRANSFERASE LEVELS IN MALARIA PATIENTS

Abstract

Objective: To study thrombocytopenia and elevated ALT levels in malaria patients reporting to Pak Med Level II+ Hospital XII and XIII, UN Mission Liberia, West Africa.

Study Design: Cross sectional study.

Place and Duration of Study: Departments of Pathology and Medicine, Pak Med Level II+ Hospital XII and XIII, UN Mission Liberia, West Africa, from Feb 2015 to Dec 2016.

Methodology: In total of 100 febrile patients of both gender and all ages reported to Pak Med Level II+ Hospital XII and XIII, Liberia with clinical features of malaria and having positive malarial parasite (MP) on any of the methods of immune chromatography (ICT) or microscopic film were included. The febrile patients with typical clinical features of malaria but having negative MP both on ICT and microscopic methods were excluded.
Pretreatment whole blood in EDTA was collected for testing MP on ICT and by microscopic method including MP index and platelets, while serum for ALT.

Results: Out of total 100 patients, 75 were males, 25 females with mean age of 38 ± 5 years. MP was found positive on MP film in 95% and on ICT in 88% cases. Thrombocytopenia was found in 69% and ALT was elevated in 60% cases. Mean and SD for platelets count was 129 ± 72 x 109/L and of ALT 76 ± 66 U/L. Mean of MP index was 0.49 ranging from 0 to 3.5%. Correlation of MP index with platelets and ALT was found insignificant, although in malaria patients, platelets and ALT was inversely correlated significantly with each other showing low platelets along with elevated ALT levels.

Conclusion: In malaria patients, thrombocytopenia and elevated ALT are frequent findings, which may not definitely correlate with MP index. So it is advisable to test for platelet count and ALT in all patients of malaria for early diagnosis and better management.