Jemds.com Original Article J. Evolution Med. Dent. Sci./ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 5/ Issue 30/ Apr. 14, 2016 Page 1548 VARIATION OF HAEMATOLOGICAL INDICES IN MALARIA FEBRILE ILLNESSES Avinash Gupta 1 , Pushpraj Singh Baghel 2 , Ankana Thakur 3 , Vikash Jain 4 , Neeraj Jain 5 1 Senior Resident, Department of Pathology, NSCB Medical College, Jabalpur. 2 Assistant Professor, Department of Pathology, NSCB Medical College, Jabalpur. 3 Senior Resident, Department of Pathology, NSCB Medical College, Jabalpur. 4 Senior Resident, Department of Pathology, NSCB Medical College, Jabalpur. 5 Assistant Professor, Department of Medicine, NSCB Medical College, Jabalpur. ABSTRACT BACKGROUND Malaria is an epidemiological problem at the global level caused by the Plasmodium species. In Indian subcontinent, it is a major cause of mortality and considered as the main differential diagnosis of acute febrile illness. The parasite mainly infects the erythrocytes and causes various haematological abnormalities like anaemia, thrombocytopenia and Disseminated Intravascular Coagulation (DIC). AIM To evaluate the diagnostic relevance of haematological parameters in predicting malaria. SETTINGS AND DESIGN Hospital based prospective cohort study. MATERIALS AND METHODS Blood samples from febrile patients were tested for malaria by the peripheral blood smear study; 100 smear positive malaria cases detected at Central Laboratory Department of Pathology, N.S.C.B. Medical College, Jabalpur, MP, during the period of September 2011 to October 2012, were selected and studied for haematological changes using an automated cell counter. The patients already taking antimalarial drugs were excluded. RESULTS Out of the 100 smear positive malaria cases detected, 63% had P. vivax infection, while 35% were infected with P. Falciparum and 2% had mixed infection. Thrombocytopenia (platelet count less than 150,000/mm3) was seen in 88% patients and the degree of parasitaemia correlated with extent of thrombocytopenia, the Correlation Co-efficient (r) was–0.46 (P<0.0001), which is highly significant. Anaemia (Hb<11 gm%) was seen in 81% of the cases. Degree of parasitaemia correlated with the degree of anaemia and the Correlation Co-efficient (r) was–0.50 P<0.0001), which is highly significant. Changes in RDW, MPV and leukocyte count were also predictive. CONCLUSION The conclusion of this study is that the presence of thrombocytopenia and anaemia in a patient with acute febrile illness increases the probability of malarial infection and they are more pronounced in P. falciparum infection. Degree of anaemia, RDW and thrombocytopenia usually correlates with parasite load. KEYWORDS Malaria, Thrombocytopenia, Anaemia, Fever, Haematological Changes. HOW TO CITE THIS ARTICLE: Gupta A, Baghel PS, Thakur A, et al. Variation of haematological indices in malaria febrile illnesses. J. Evolution Med. Dent. Sci. 2016;5(30):1548-1552, DOI: 10.14260/jemds/2016/364 INTRODUCTION Malaria is a major health problem in the tropics with 300-500 million cases of malaria occurring annually and an estimated 1.1-2.7 million deaths each year as a result of severe malaria. [1] Malaria is an acute, recurrent and sometimes chronic vector- borne protozoan disease, which has worldwide distribution in tropical and subtropical regions. Financial or Other, Competing Interest: None. Submission 22-02-2016, Peer Review 18-03-2016, Acceptance 24-03-2016, Published 13-04-2016. Corresponding Author: Dr. Pushpraj Singh Baghel, F-44, Doctors Colony, NSCB Medical College, Garha, Jabalpur, Madhya Pradesh. E-mail: drpushprajsingh@gmail.com DOI: 10.14260/jemds/2016/364 The main areas where disease predominates are the rural and remote areas, where prompt treatment is not available or not detected in time. Malaria causing plasmodia is a parasite of blood and hence induces various haematological changes; some of these changes may be species specific. Red Blood Cell Changes in Malaria Anaemia is one of the most common haematological alterations in Malaria. One arbitrary definition of malarial anaemia in such a setting would be haemoglobin less than 8 g/dL, which is equivalent to a haematocrit of less than 24% in a parasitaemic individual. Definition of Severe Malarial Anaemia (SMA) is less problematic. The World Health Organization has defined SMA as haemoglobin less than 5 g/dL or a haematocrit less than 15% seen in the context of malaria, but without specifying parasitaemia. Blood indices (MCV,