背景:血液学异常是恶性疟疾的共同特征,但各国不同人群之间存在差异。因此,我们比较了白尼罗河州科斯蒂市恶性疟原虫感染患者和疟疾阴性受试者之间的血液学指标和异常,苏丹。
方法:比较,横断面研究于2018年6月至12月在Kosti教学医院临床实验室进行.该研究共招募了392名参与者(192名恶性疟原虫感染患者和200名疟疾阴性受试者)。血红蛋白(Hb)的血液学指标,红细胞(RBC),测量白细胞(WBC)和血小板,和它们的中值进行了统计学比较。
结果:大多数恶性疟原虫感染患者(67.6%)表现出低水平的寄生虫血症。Hb浓度的中值,红细胞计数,平均红细胞体积(MCV),恶性疟原虫感染患者的平均红细胞Hb(MCH)和平均红细胞Hb浓度(MCHC)显着降低,而与疟疾阴性受试者相比,患者的红细胞分布宽度中位数(RDW)明显更高。贫血,MCV低,低MCH,低MCHC和高RDW与恶性疟疾显著相关,但寄生虫血症水平与贫血严重程度无显著相关.在恶性疟原虫感染的患者中,白细胞总数的中位数没有显着升高,中性粒细胞减少症与恶性疟疾显著相关。恶性疟原虫感染患者的血小板计数中位数明显较低,血小板减少症与恶性疟疾显著相关。
结论:白尼罗州科斯蒂市患者中的恶性疟疾,苏丹主要是低水平的寄生虫血症。它与贫血显著相关,MCV低,低MCH,低MCHC,高RDW,血小板减少和中性粒细胞减少。然而,寄生虫血症水平不是贫血严重程度的重要预测指标。另一方面,白细胞减少对预测恶性疟疾没有帮助。建议在社区和医疗机构进行进一步的大规模研究,并纳入复杂或严重疟疾患者以及寄生虫密度高的患者。
BACKGROUND: Hematological abnormalities are common features in falciparum malaria but vary among different populations across countries. Therefore, we compared hematological indices and abnormalities between Plasmodium falciparum-infected patients and malaria-negative subjects in Kosti city of the White Nile State, Sudan.
METHODS: A comparative, cross-sectional
study was conducted at the Clinical Laboratory Unit of Kosti Teaching Hospital from June to December 2018. A total of 392 participants (192 P. falciparum-infected patients and 200 malaria-negative subjects) were recruited in the
study. Hematological indices of hemoglobin (Hb), red blood cells (RBCs), white blood cells (WBCs) and platelets were measured, and their median values were statistically compared.
RESULTS: The majority of P. falciparum-infected patients (67.6%) showed a low-level parasitemia. The median values of Hb concentration, RBC count, mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and mean corpuscular Hb concentration (MCHC) were significantly lower in P. falciparum-infected patients, while the median red cell distribution width (
RDW) was significantly higher in the patients compared to malaria-negative subjects. Anemia, low MCV, low MCH, low MCHC and high
RDW were significantly associated with falciparum malaria, but parasitemia level was not significantly associated with anemia severity. The median total WBC count was non-significantly higher in P. falciparum-infected patients, with neutropenia being significantly associated with falciparum malaria. The median platelet count was significantly lower in P. falciparum-infected patients, with thrombocytopenia being significantly associated with falciparum malaria.
CONCLUSIONS: Falciparum malaria among patients in Kosti city of the White Nile State, Sudan is predominantly of low-level parasitemia. It is significantly associated with anemia, low MCV, low MCH, low MCHC, high
RDW, thrombocytopenia and neutropenia. However, parasitemia level is not a significant predictor of anemia severity. On the other hand, leucopenia is not useful to predict falciparum malaria. Further large-scale studies in community and healthcare settings and inclusion of patients with complicated or severe malaria and those with high parasite densities are recommended.