Haematological parameters, haemozoin-containing leukocytes in Sudanese children with severe Plasmodium falciparum malaria

  • Magdi M Salih University of Khartoum, Khartoum, Sudan
  • Hatim G Eltahir Singa Hospital, Singa, Sudan
  • Tajeldin M Abdallah Kassala University, Kassala, Sudan
  • Tariq E Elmahdi Sudan University of Science and Technology, Khartoum, Sudan
  • Ammar H Khamis Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
  • Elfatih E Malik University of Khartoum, Khartoum, Sudan
  • Ishag Adam University of Khartoum, Khartoum, Sudan
Keywords: haematological profile, haemozoin, PDW, MPV, Plasmodium falciparum, Sudan

Abstract

Introduction: Haemozoin –containing leucocytes (HCL) can be used to predict severe malaria.

Methodology: A case –control study was conducted in Singa, Sudan, to investigate the haematological values and HCL in children with severe Plasmodium falciparum malaria. The cases were children with severe P. falciparum malaria (67). The two groups of controls were patients with uncomplicated P. falciparum malaria (63) and healthy children (50).

Results: The mean (±SD) age was 5.5 (±3.8) years. In comparison with children with uncomplicated P. falciparum malaria, children with severe P. falciparum malaria had significantly lower haemoglobin and platelet counts, and significantly higher lymphocyte counts, red cell distribution width (RDW), and platelet distribution width (PDW). The rate of haemozoin –containing monocytes (percentage of children positive for this parameter in each group) was 91.0%, 84.6% and 50.0%, P<0.001 in children with severe P. falciparum, uncomplicated P. falciparum malaria and negative controls, respectively. Receiver Operating Characteristic (ROC) curves for blood parameters and HCL were plotted and the areas under the curve (AUC) were calculated for the prediction of severe P. falciparum malaria infection. The ROC curve analysis, showed a fair predictability of malaria for haemoglobin (AUC = 0.74, sensitivity = 76.0% and specificity  = 60.3%, cut-off  = 9.7g/dl), lymphocytes (AUC = 0.71, sensitivity = 71.3% and specificity  = 62.2%, cut-off  = 1.95×103/mm3), PDW (AUC = 0.69, sensitivity = 80.1% and specificity = 66.3%, cut-off  = 15.34 %) and haemozoin in the monocytes (AUC = 0.68, sensitivity = 68.2% and specificity = 65.2%, cut-off =5.5 %).

Conclusion: RDW, PDW and HCL could be used to predict severe malaria in this setting.

Author Biographies

Magdi M Salih, University of Khartoum, Khartoum, Sudan

Faculty of Medical Laboratory Sciences

Hatim G Eltahir, Singa Hospital, Singa, Sudan

Ministry of Health

Tajeldin M Abdallah, Kassala University, Kassala, Sudan

Faculty of Medicine

Tariq E Elmahdi, Sudan University of Science and Technology, Khartoum, Sudan

Department of Hematology, College of Medical Laboratory Sciences

Ammar H Khamis, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates

Hamdan Bin Mohammed College of dental medicine (HBMCDM)

Elfatih E Malik, University of Khartoum, Khartoum, Sudan

Faculty of Medicine

Ishag Adam, University of Khartoum, Khartoum, Sudan

Faculty of Medicine

Published
2018-04-30
How to Cite
1.
Salih M, Eltahir H, Abdallah T, Elmahdi T, Khamis A, Malik E, Adam I (2018) Haematological parameters, haemozoin-containing leukocytes in Sudanese children with severe Plasmodium falciparum malaria. J Infect Dev Ctries 12:273-278. doi: https://doi.org/10.3855/jidc.9906
Section
Brief Original Articles