Association of Thrombocytopenia and prolong bleeding time in children suffering from Malaria

Objective: To determine the association of thrombocytopenia and prolong bleeding time in children suffering from malaria. Study design: Cross sectional descriptive study Setting: Department of pediatrics Liaquat University Hospital Hyderabad. Duration: Six month from 24th June 2014 to 23rd December 2014 Subjects and methods: All children presenting in pediatrics department of Liaquat University Hospital Hyderabad with fever (>101 oF) or history of fever (>101 oF) for 3 days duration were evaluated for malaria parasite through thick and thin blood smear. Then all malaria positive patients were assessed for platelet count. Thrombocytopenia; if present then further evaluated for their bleeding time (BT) by Duke’s method and observation were noted. Results: Total 154 children of malaria were included in this study mean age + SD (range) was 5.76 + 3.63 (6 months to 12 years). 118 cases were plasmodium vivax positive while 34 were suffering from plasmodium falciparum malaria, whereas 02 children had mixed (p. vivax and p. falciparum) infection. Out of 154 children of malaria, 100(65.0%) had decreased platelets count. Of these, 71(71.0%, n =100) had mild thrombocytopenia, 26(26.0%, n = 100) had moderate thrombocytopenia, while severe thrombocytopenia was observed in 3(3.0%, n = 100). Prolonged bleeding time was observed in those children who had thrombocytopenia. Out of 100 cases of thrombocytopenia, prolonged bleeding time (> 8 minutes) was seen in 8(8.0%, n = 100) cases. Of these, 5(62.5%, n = 8) children had moderate thrombocytopenia while 3(37.5%, n = 8) had severe thrombocytopenia. Conclusion: This study concluded that various degree of thrombocytopenia is common with malaria from asymptomatic to prolong bleeding time leading to life threatening bleeding require early diagnosis and prompt management.