ABSTRACT
Objectives: To compare and correlate hepatic and hematological parameters in patients with Vivax and Falciparum Malaria
Study design: A retrospective comparative study
Place and duration: The study was conducted the Department of Biochemistry, Basic Medical Sciences Institute with collaboration of National Institute of Child Health and malaria control program counter at Jinnah Postgraduate Medical Center Karachi during 1st August 2005 to 31st December 2006
Methodology: The study included 120 consecutive patients. All patients were between 1 to 10 years of age. They were divided equally into two groups, Plasmodium vivax malaria [Group A] and Plasmodium falciparum malaria [Group B]. Those patients having a history of icterus, taking hepatotoxic drugs or had evidence of hepatic dysfunction were excluded from the study. Liver function tests and hematological parameters performed
Results: All patients had fever, chills with rigors and body aches. On evaluation an increasing tendency of jaundice and hepatosplenomegaly along with statistically significant value [p<0.05] in serum bilirubin, alanine transaminase [ALT], hemoglobin, bleeding time [BT] and prothrombin time [PT] was found in patients with Falciparum as compared to vivax malaria. In Group A, serum bilirubin has negative correlation with hemoglobin but positive with PT. PT has negative correlation with ALT but positive with aspartate transaminase [AST]. Platelet has negative correlation with ALT but positive with alkaline phosphatase [ALP]. In Group B, hemoglobin has negative correlation with bilirubin, ALT and AST but positive with ALP; serum AST, and ALT were negatively correlated with, platelet and PT but positive with bleeding and clotting time. Platelets have significant coefficient correlation [0.524] regarding total protein and clotting time shows significant coefficient correlation [0.606] with alanine transaminase shown in table- 111
Conclusions: Liver function test and hematological parameters should be performed in patients with diagnosed Plasmodium Falciparum Malarial infection to prevent complication
ABSTRACT
Falciparum malaria is responsible for 1-3 million deaths annually worldwide. Liver involvement is common and may manifest as raised serum bilirubin, hepatomegaly and elevated liver enzymes. Unconjugated hyperbilirubinemia is usually seen leading to increased mortality. Alanine aminotransferase [SGPT] is a marker of liver damage. The present study was conducted on Plasmodium falciparum malarial patients to observe the correlation between liver enzymes and bilirubin. To observe the correlation coefficient of bilirubin with liver enzymes [SGPT, SGOT and Alkaline Phosphatase] in patients of falciparum malaria. A Descriptive study. Department of Biochemistry, Basic Medical Sciences Institute, JPMC, Karachi from August 2005 to July 2006. Total 81 patients of different ages and both sexes suffering from acute malaria, were selected by convenient sampling. Nine patients, infected by Hepatitis B and C infections were excluded from the study. Among remaining 72 cases, 48 [70%] were suffering from infection by Plasmodium falciparum and 24 [30%] from infection by Plasmodium vivax infection. The Falciparum infected patients were equally divided into two groups on the basis of duration of illness. Group I having 1- 7days illness and Group II having duration of 8-20 days. Patients suffering from plasmodium vivax infection and illness of 1 - 20 days were placed in Group III. In the group I, SGPT and Alkaline phosphatase showed a statistically significant positive correlation r=0.50 and r=0.054, respectively with bilirubin [P<0.05]. In group II, the SGPT showed a statistically excellent positive correlation [r=0.88; P<0.01], while the SGOT and Alkaline phosphatase also showed a statistically significant positive correlation. In group III both aminotransferases and Alkaline phosphatase showed a statistically significant positive correlation r=0.82, 0.63 and 0.69 respectively. Positive correlation of liver enzymes and bilirubin shows that liver function tests should be performed along with early diagnosis of Plasmodium falciparum malarial infections in order to prevent complications and to reduce mortality