Evaluation of Hematological Parameters in Malaria Patients and Their Correlation with Disease Complications

Abstract

Malaria remains a major public health challenge worldwide, particularly in tropical and subtropical regions, with hematological alterations being among its most consistent features and serving as valuable diagnostic and prognostic markers. This hospital-based cross-sectional study, conducted at Hayatabad Medical Complex, Peshawar, from January to July 2025, aimed to evaluate hematological parameters in malaria patients and determine their correlation with malaria-related complications. A total of 110 patients aged 15–60 years with confirmed malaria were included, and hematological parameters including hemoglobin, hematocrit, red blood cell count, total and differential leukocyte count, and platelet count were measured using an automated hematology analyzer. Statistical analysis was performed using Student’s t-test, Chi-square test, and Pearson’s correlation coefficient, with a p-value <0.05 considered significant. Results showed that anemia was present in 68% of patients, with a mean hemoglobin of 9.8 ± 2.4 g/dL, while thrombocytopenia was the most common abnormality, observed in 72% of cases; additionally, 62% had low hematocrit, 55% had reduced red blood cell counts, and 30% exhibited abnormal total leukocyte counts (18% leukopenia and 12% leukocytosis), with lymphopenia noted in 15%. Severe anemia (22 patients) and cerebral malaria (14 patients) were significantly associated with lower hemoglobin and platelet counts (p<0.01). Hematological abnormalities were more frequent in Plasmodium falciparum infections compared to P. vivax, while mixed infections demonstrated the highest prevalence of anemia and thrombocytopenia. The study concludes that hematological abnormalities are common in malaria, with anemia and thrombocytopenia being the most frequent and clinically significant alterations, particularly in P. falciparum and mixed infections, and these derangements are strongly associated with complications. Routine hematological evaluation, therefore, provides a simple and cost-effective tool for diagnosis, risk stratification, and early management of malaria in endemic regions.

Keywords: Malaria; Plasmodium Falciparum; Plasmodium Vivax; Hematological Abnormalities; Anemia; Thrombocytopenia; Leukocyte Count; Prognostic Markers