Some haematological and biochemical changes associated with malaria parasitaemia in adults attending tertiary outpatient clinics in Edo State, Nigeria

Abstract

Background: Malaria is a major public health problem in Nigeria affecting virtually all age- groups. However, reports are scant on malarial-parasite-induced complications of the hematopoietic system and liver functions, particularly in adult out-patients in Edo state, Nigeria. Aim: As aim of the study, we set out to investigate malaria-parasitaemia in malaria adults and to assess changes in some haematological and biochemical parameters prior to treatment, in order to institute effective supportive care.

Material and Methods: This case-control study included 168 malaria-positive adults attending out-patient clinics in two tertiary health centres in Edo state, Nigeria and 84 age- and sex-matched healthy community-controls. Malarial-parasite estimation was based on de-hemoglobinized Giemsa-stained blood-smear microscopy. Standard techniques with the aid of auto-analyzers were employed for haematological and biochemical analyses.

Results: Malarial parasite density prevalence showed that 28(16.7%), 72(42.9%), 46(27.4%) and 22(13.1%) presented with ‘Low’, ’Mild’, ‘Moderate’ and ‘High parasitaemia respectively. Hemoglobin (Hb), Packed Cell Volume (PCV), Total Lymphocytes, CD4+T and platelets levels declined significantly among malaria patients compared to control, whereas Neutrophils increased, p<0.0001 for each parameter and slightly insignificant difference observed in the White Blood Cells(WBC) count, P=0.58.Conversely, serum Aspartate aminotransferase (AST), Alanine aminotransferase (ALT),Alkaline Phosphatase (ALP) and Bilirubin were significantly elevated, P<0.0001.

Conclusion: Defective hematopoiesis, hepatic hyperactivity and hyperbilirubinemia were prevalent among adult malaria patients studied. However, the decline in severity of malaria-parasitaemia with increasing age, despite hematopoietic and hepatic derangement, suggests the acquisition of partial non-sterile anti-malaria immunity in adulthood. These findings could be helpful in the management of adulthood malaria in endemic settings.

Keywords: Adults; Biochemical; Haematological indices; Malaria; Partial immunity