Temporal evolution of hemogram in children with malaria

Abstract

Introduction: There are few Colombian studies about the relations between malaria, intestinal parasites, malnutrition and the hemogram.

Objectives: To know the temporal evolution of hemogram in children with malaria (aged 4-10 years) followed during 30 days.

Methodology: This study is part of a larger project, which has a non-blinded balanced experimental design.

Results: 93 children were evaluated. Malnutrition risks were as follows: 52% chronic, 47% global, 15% acute. 88% had intestinal parasites (80% of them were pathogens) and 35% were polyparasitized. Hemoglobin (average in g/dL) at days 1 and 8: 10.3 and at day 30: 11.8. Chronic malnutrition and intestinal parasites did not significantly influence hemoglobin levels at days 1 and 30. Apparently, malnutrition had more influence (although not statistically significant) than intestinal parasites. During the acute episode of malaria, the leukocyte count was normal and it changed to very mild leukocytosis within the next 30 days. Leukocyte analysis revealed decreased neutrophils and basophils, increased eosinophils, mild lymphocytosis and marked monocytopenia, both of them stable. Lymphocytosis and monocytopenia were in contrast with the findings of other studies.

Conclusions: These children with malaria (90% P. vivax), intestinal parasites and chronic malnutrition, had anemia (mild, homogeneous, normocytic) before therapy, but they recovered from it in 30 days after effective antimalarial treatment; 80% also suffered from thrombocytopenia; at day 1, they showed neutropenia, basopenia, and eosinophilia, along with normal lymphocytes and severe monocytopenia. It is necessary to treat simultaneously these diseases in order to improve the health status of these children.