Diagnostic Utility of Platelet Count and Platelet Indices in Malaria Among Patients Presenting with Acute Febrile Illness
DOI:
https://doi.org/10.55629/pakjpathol.v37i3.1026Abstract
Objective: To evaluate platelet count and platelet indices as adjunctive diagnostic markers for malaria in patients with acute febrile illness and compare these parameters in Plasmodium vivax and Plasmodium falciparum infections.
Methods: This cross-sectional analytic study was conducted from May to December 2025 at Karachi Institute of Medical Sciences and Diagnostic and Research Laboratory, LUMHS, Karachi. A total of 468 eligible patients were enrolled. Platelet count, plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) were compared between malaria-positive and malaria-negative patients and between P. vivax and P. falciparum infections. Receiver operating characteristic (ROC) curve analysis was performed to evaluate diagnostic performance.
Results: Malaria was confirmed in 295 (63.0%) patients, of whom 263 (89.2%) had P. vivax infection. Malaria-positive patients had significantly lower platelet count and PCT, and higher MPV, PDW, and P-LCR than malaria-negative patients (all p<0.05). Moderate-to-severe thrombocytopenia occurred in 68.5% of malaria-positive patients compared with 2.9% of malaria-negative patients (p<0.001). Platelet count and PCT demonstrated excellent diagnostic performance, with area under the curve (AUC) values of 0.971 and 0.970, respectively. MPV, PDW, and P-LCR showed poor diagnostic performance. No significant differences in platelet indices were observed between P. vivax and P. falciparum infections.
Conclusion: Platelet count and plateletcrit are inexpensive, readily available adjunctive markers for the early recognition of malaria in patients with acute febrile illness, whereas MPV, PDW, and P-LCR have limited diagnostic utility. Platelet alterations were not species-specific.
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