Thrombocytopenia as a Diagnostic Marker for Malaria in Patients with Acute Febrile Illness

Angesom Gebreweld; Yonas Erkihun; Daniel Getacher Feleke; Gebru Hailu; Temesgen Fiseha

doi:10.1155/2021/5585272

Thrombocytopenia as a Diagnostic Marker for Malaria in Patients with Acute Febrile Illness

J Trop Med. 2021 Apr 10:2021:5585272. doi: 10.1155/2021/5585272. eCollection 2021.

Authors

Angesom Gebreweld¹, Yonas Erkihun², Daniel Getacher Feleke³, Gebru Hailu⁴, Temesgen Fiseha²

Affiliations

¹ Department of Medical Laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
² Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
³ Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁴ Department of Environmental Health and Behavioral Science, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.

Abstract

Background: Thrombocytopenia is the most common hematological abnormality in patients with acute malaria. This study aimed to determine the role of thrombocytopenia as a diagnostic marker for malaria in patients with acute febrile illness.

Method: A cross-sectional health facility-based study was conducted on 423 consecutively selected acute febrile patients at Ataye District Hospital from February to May 2019 GC. A complete blood count and malaria microscopy were performed for each acute febrile patient. ROC curve analysis was performed to calculate sensitivity, specificity, positive predictive value, and negative predictive value of platelet count in predicting malaria. A P ≤ 0.05 was considered statistically significant.

Result: Out of the 423 acute febrile patients, 73 (17.3%) were microscopically confirmed malaria cases and the rest 350 (82.7%) patients had negative blood film results. Of the microscopically confirmed malaria cases, 55 (75.34%) were P. vivax and 18 (24.66%) were P. falciparum. The prevalence of thrombocytopenia among malaria patients (79.5%) was significantly higher than those in malaria negative acute febrile patients (13.7%), P < 0.001. About 67% malaria-infected patients had mild to moderate thrombocytopenia and 12.3% had severe thrombocytopenia. The ROC analysis demonstrated platelet counts <150,000/μl as an optimal cutoff value with 0.893 area under the curve, 79.5% sensitivity, 86.3% specificity, 95.3% negative predictive value, and 54.7% positive predictive value to predict malaria.

Conclusion: Malaria is still among the major public health problems in the country. Thrombocytopenia is a very good discriminatory test for the presence or absence of malaria with 79.5% sensitivity and 86.3% specificity. Therefore, this may be used in addition to the clinical and microscopic parameters to heighten the suspicion of malaria.