RESUMEN
Background: Malaria, is endemic in Surat, (an industrious city of Gujarat), which is categorised under High risk zone. Malaria affects all blood components and is a true haematological disease. Thrombocytopenia and anaemia are the most frequently malaria associated haematological complications of malaria. Aims & Objective: To study the occurrence, severity and correlation of Thrombocytopenia in urban children with malaria. Materials and Methods: A retrospective study was conducted at Surat Municipal Institute Of Medical Education and Research (SMIMER) , Surat Gujarat . The Data of all smear positive and Rapid Diagnostic Test positive malaria cases of age between 1 and 17 year admitted in the Deptt. Of Pediatrics were collected. These patients were further assessed for thrombocytopenia, its severity, its relation with type of malaria and age. Results: Thrombocytopenia was observed in 233 (74%) cases of Malaria of which P. vivax was in 103 (44%) cases, P. falciparum in 130(56%) cases. Severe thrombocytopenia was observed in 22% and 29% cases of Pv and Pf malaria respectively. Sensitivity of thrombocytopenia in Pv and Pf was 71.53% and 76.92% whereas specificity was 66.67 for both respectively. Sensitivity of thrombocytopenia in Pv increased as the platelet count decreased. Conclusion: Thrombocytopenia is a frequent overall manifestation of both falciparum and Vivax malaria Severe Thrombocytopenia should alert one to consider a possibility of malaria in children.
RESUMEN
Background & objectives: Despite major control efforts, malaria remains a major public health problem that still causes high mortality rate worldwide especially in Africa and Asia. Accurate and confirmatory diagnosis before treatment initiation is the only way to control the disease. The present study was undertaken to develop reagents using sandwich ELISA for simultaneous detection of PfHRP2 (Plasmodium falciparum histidine rich protein) and PfLDH (P. falciparum lactate dehydrogenase) antigens in the proven malaria cases. Methods: The antibodies were raised against two epitopes of PfHRP2 protein and three unique and unexplored epitopes of PfLDH protein. These antibodies were able to detect PfHRP2 and PfLDH antigens in culture supernatant and parasitized RBC lysate of P. falciparum, respectively up to 50 parasites/μl. The in-house reagents were tested in 200 P. falciparum positive patients residing in Baghpat district of Uttar Pradesh in northern India. Results: Microsphere (PLGA) with CpG ODN were used to generate high titre and high affinity antibodies against selected peptides of PfHRP-2 and pLDH antigen in mice and rabbit. The peptide specific peak titre varied from 12,800 - 102,400 with an affinity ranging 0.73 - 3.0 mM. The indigenously developed reagents are able to detect PfHRP2 and PfLDH antigens as low as 75 parasites/μl of blood with a very high sensitivity (96-100%) and specificity (100%). Interpretation & conclusions: The study highlight the identification of unique epitopes of PfHRP2 and PfLDH, and the generated antibodies against these antigens were used for quantitative estimation of these two antigens using sandwich ELISA. No corresreactivity with P. vivax infected patients was observed with the sera.