Circulating platelets and malaria severity: Two sides of the same coin among inhabitants of a Tropical Savannah region, Nigeria

Abstract

Abstract Changes in circulating platelets during different grades of malaria is of major concerns and its etiology is poorly understood. We appraised and evaluated the role of circulating platelets in the determination of severity of malaria among a cohort of outpatients living in Ilorin, Nigeria. A hospital-based cross sectional cohort of outpatients visiting public health facilities within the locality voluntarily enrolled for this study. Blood samples from 1,162 malaise patients were screened using routine protocols for Plasmodium parasite species identification, clinical conditions and circulating platelet levels. Seven hundred and seventy five individuals (775, 66.7%, p < 0.001) were malaria-positive. Samples from 387 (33.3%) uninfected healthy individuals were used as controls. Individuals with uncomplicated malaria (UCM) and complicated malaria (CM) across age-group was notable (p < 0.05). Children ≤ 5yrs had the highest number of individuals with CM (103, 45.2%) with relative risk ratio of 4.005 (95% CI: 2.964–5.413). UCM (471, 40.5%) occurred more than CM (304, 26.2%) (p > 0.05) across the groups. The geometric mean, 95% CI, median and IQR of populations with malaria thrombocytopenia were higher (181, 110.94 ± 2.207, 106.59–115.30, 118.00, and 39.00) than thrombocytosis (78, 624.64 ± 13.131, 598.49-650.79, 623.00 and 208). Seemingly, health controls recorded insignificant morbidity with respect to platelet counts. High P. falciparum parasitaemia count is reflective of platelet clump and the manifestation of several malaria pathogenesis. It is expedient to administer antipyretics as a premedication during febrile presentation.