A comparative study assessing the effect of haematological and biochemical parameters on the pathogenesis of malaria

  • Sindhusuta Das
  • Nonika RajkumariEmail author
  • Palanivel Chinnakali
Original Article


Malaria is one of the most common parasitic disease affecting mankind since millennia. The most pronounced changes related to malaria involve the blood and the blood forming system, the spleen and the liver. The abnormal haematological and biochemical parameters observed in malaria cases adversely affect the prognosis of the disease. The aim of this study was to assess the severity of malaria by observing the significant abnormalities in haematological and biochemical parameters in the malaria infected cases as compared to the healthy controls. The study population comprised of 138 individuals, of which 69 were malaria cases and 69 were apparently healthy controls. All the 138 individuals were subjected to haematological and biochemical workup, following which statistical analysis was done to observe any association of altered haematological and biochemical parameters with severity of malaria, as compared to the healthy controls. Among the 138 study population, 69 patients were malaria cases whereas the other 69 were healthy controls. Haematological investigations revealed, that the haemoglobin levels, total RBC counts and haematocrit were significantly altered in the malaria cases as compared to the healthy controls. Also the leucogram profile showed significant leucopenia and neutropenia in the malaria patients as compared to the controls. Thrombocytopenia was also seen to be more pronounced in the malaria infected. The liver enzymes and serum bilirubin levels were raised in the malaria cases more than the controls. Altered haematological and biochemical parameters are indicators of disease progression to severity. Early detection and management of these parameters, will prevent the development of complications in malaria.


Malaria Anaemia Haematological abnormalities Biochemical abnormalities Plasmodium 


Author’s contribution

Dr. SD was responsible for sample and data collection, its processing and microscopy. She was responsible for writing the manuscript and its submission. Dr. NR was responsible for the conceptualization of the study, counterchecking the results and monitoring of the work carried out and analysis of the results. She also checked and refined the manuscript and also gave critical inputs to the paper. Dr. PC helped in the statistical modelling of the study, selection of the study parameters as well as gave critical inputs to the study and helped in refining the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval was given by the JIPMER ethical committee.

Informed consent

Informed consent has been taken from all the enrolled participants during the study.


  1. Abdulkareem BO, Adam AO, Ahmed AO, Mariam AA, Samuel UU (2017) Malaria-induced anaemia and serum micronutrients in asymptomatic Plasmodium falciparum infected patients. J Parasit Dis 41(4):1093–1097CrossRefGoogle Scholar
  2. Abro AH, Ustadi AM, Abro HA, Abdou AS, Younis NJ, Akaila SI (2009) Jaundice with hepatic dysfunction in P. falciparum malaria. J Coll Physicians Surg Pak 19(6):363–366Google Scholar
  3. Agrawal N, Nath K, Chandel K, Singh M, Agrawal P, Archana et al (2015) Hematological changes in malaria. J Evol Med Dental Sci 8672. [Cited 10 Jan 2019]
  4. Al-Salahy M, Shnawa B, Abed G, Mandour A, Al-Ezzi A (2016) Parasitaemia and its relation to hematological parameters and liver function among patients malaria in Abs, Hajjah, Northwest Yemen. Interdiscip Perspect Infect Dis. [Cited 5 Jan 2019]
  5. D’souza JJ, Jayaprakash C, D’souza P, Abraham S, Suresh S, Shrinath M (2017) Comparative hematological changes in malarial infection by P. vivax and P. falciparum: observations from the endemic region of Mangalore, India. Int J Appl Res 3(6):179–183Google Scholar
  6. Das BP, Ganguly R, Khuntia HK, Bal M, Ranjit M (2017) Hematological changes in severe P. falciparum malaria. Int J Curr Microbiol Appl Sci 6(6):1733–1739CrossRefGoogle Scholar
  7. Francis U, Isaac Z, Yakubu A, Enosakhare A, Felix E (2014) Haematological parameters of malaria infected patients in the University of Calabar Teaching Hospital, Calabar, Nigeria. J Hematol Thromb Dis 2:6CrossRefGoogle Scholar
  8. Godse RR (2013) Hematological and biochemical evaluation in malaria patients with clinical correlation. IJRRMS 3:28–31Google Scholar
  9. Jairajpuri ZS, Rana S, Hassan MJ, Nabi F, Jetley S (2014) An analysis of hematological parameters as a diagnostic test for malaria in patients with acute febrile illness: an institutional experience. Oman Med J 29(1):12–17CrossRefGoogle Scholar
  10. Khatib DY, Patel DR, Sequeira DK, Agrawal DG, Chikhale N (2015) Hematological and biochemical alterations in malaria and their correlation with parasitic index. IOSR J Pharm 5:53–56Google Scholar
  11. Khuraiya P, Sharma SS, Thakur AS, Pandey VP, Verma S (2016) The study of clinical, biochemical and hematological profile in malaria patients. Int J Adv Med 3(2):209–217CrossRefGoogle Scholar
  12. Kotepui M, Phunphuech B, Phiwklam N, Chupeerach C, Duangmano S (2014) Effect of malarial infection on haematological parameters in population near Thailand–Myanmar border. Malar J 13:218CrossRefGoogle Scholar
  13. Kotresh N, Suresh S (2016) Liver function abnormalities in falciparum malaria. Int J Advan Med 3:847–850CrossRefGoogle Scholar
  14. Kurtzhals JAL, Reimert CM, Tette E, Dunyo SK, Koram KA, Akanmori BD et al (1998) Increased eosinophil activity in acute Plasmodium falciparum infection—association with cerebral malaria. Clin Exp Immunol 112(2):303–307CrossRefGoogle Scholar
  15. Martínez-Salazar EL, Tobón-Castaño A (2014) Platelet profile is associated with clinical complications in patients with vivax and falciparum malaria in Colombia. Revista da Sociedade Brasileira de Medicina Tropical 47(3):341–349CrossRefGoogle Scholar
  16. Sharma M, Nand N, Kumar H, Suman L (2012) Evaluation of liver functions in falciparum malaria. JIMSA 25:229–230Google Scholar
  17. Syamsundar B (2013) Hematological and biochemical alterations in malaria patients with clinical correlation in a tertiary care hospital. [Cited 10 Jan 2019]
  18. Tobón-Castaño A, Mesa-Echeverry E, Miranda-Arboleda AF (2015) Leukogram profile and clinical status in vivax and falciparum malaria patients from Colombia. J Trop Med. [Cited 5 Jan 2019]
  19. World Health Organization (ed) (2010) Basic malaria microscopy, 2nd edn. WHO, GenevaGoogle Scholar
  20. World Malaria Report (2018) Geneva: World Health Organization. Licence: CC BY-NC-SA 3.0 IGO. Accessed 10 July 2019

Copyright information

© Indian Society for Parasitology 2019

Authors and Affiliations

  1. 1.Department of MicrobiologyJawaharlal Institute of Postgraduate Medical Educations and ResearchPuducherryIndia
  2. 2.Department of Preventive and Social MedicineJawaharlal Institute of Postgraduate Medical Educations and ResearchPuducherryIndia

Personalised recommendations