AAS Open Research Open Peer Review Any reports and responses or comments on the article can be found at the end of the article. RESEARCH ARTICLE Impact of malaria on haematological parameters of urban, peri-urban and rural patients in the Ashanti region of Ghana: a cross-sectional study [version 1; peer review: awaiting peer review] Abdul-Hakim Mutala , Kingsley Badu , Christian Owusu , Samuel Kekeli Agordzo , Austine Tweneboah , Abbas Dawood Ackom , Matthew Glover Addo 1 Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana Kumasi Center for Collaborative Research for Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana Abstract This study aimed at investigating haematological changes in Background: malaria patients across different demographic settlements. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements, may also influence these changes, but this has rarely been studied. We conducted a hospital-based, cross-sectional study from Methods: January to December 2018 in three different settlements. A total of 598 participants were recruited. Giemsa-stained blood smears were examined to detect and quantify malaria parasitaemia, while haematological parameters were measured using a haematology analyser. The rural settlement had the highest malaria prevalence Results: compared to the other study communities (p=0.009). The difference in parasite densities across the three communities was also significant (p=0.0149). When the malaria-infected population was compared to the uninfected, there were differences in red blood cell count (p=0.0170), haemoglobin levels (p=0.0165), mean corpuscular volume (p=0.0139) and platelet counts (p<0.0001). The difference in median white blood cell (p-value <0.0001), neutrophil (p-value <0.0001) and lymphocyte (p-value <0.0269) count were significantly higher in infected patients from the peri-urban area compared to malaria patients from the rural and urban areas. There were also significant differences in platelet ( =0.0002), p plateletcrit ( =0.0041), mean platelet volume ( =0.0009) and platelet large p p cell ratio ( =0.0046) levels between patients from the urban, peri-urban and p rural areas. Patients infected with malaria generally had low red blood Conclusions: cell, haemoglobin and platelets in comparison to uninfected patients. There were also significant differences in several haematological parameters 1 1,2 2 1 1,2 1 1 1 2 Reviewer Status AWAITING PEER REVIEW 29 Jul 2019, :27 ( First published: 2 ) https://doi.org/10.12688/aasopenres.12979.1 29 Jul 2019, :27 ( Latest published: 2 ) https://doi.org/10.12688/aasopenres.12979.1 v1 Page 1 of 9 AAS Open Research 2019, 2:27 Last updated: 29 JUL 2019