Retrospective cross-sectional study reveals thrombocytopenia in nearly nine percent of adults with malaria, suggesting low platelets can support clinical suspicion during acute febrile illness.
Malaria is associated with haematological abnormalities, including thrombocytopenia. This study determined the frequency of thrombocytopenia among adults with malaria in Merowe City, Sudan, and compared its occurrence between Plasmodium falciparum and Plasmodium vivax infections. We conducted a retrospective cross-sectional study at Al-Gawda and Al-Ehsan Medical Centres in Merowe City, Northern State, Sudan, from November 2021 to September 2022. De-identified records of adults aged >18 years with confirmed malaria were reviewed. Complete blood count, malaria blood-film, and immunochromatographic test results were extracted. Thrombocytopenia was defined as a platelet count <150,000/mm³. Descriptive analyses were performed using SPSS version 16.0. Of 149 adults with malaria, 100 (67.1%) had P. falciparum and 49 (32.9%) had P. vivax. Thrombocytopenia was identified in 13 patients (8.7%). It occurred in 8/100 (8.0%) patients with P. falciparum and 5/49 (10.2%) patients with P. vivax. Minor bleeding was reported in one patient with P. vivax; no bleeding was reported among patients with P. falciparum. Thrombocytopenia occurred in approximately one in eleven adults with malaria and was slightly more frequent among patients with P. vivax than among those with P. falciparum. In patients presenting with acute febrile illness, thrombocytopenia may support clinical suspicion of malaria, although it should not be considered a stand-alone diagnostic test. Larger prospective studies are warranted.
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Makkawi et al. (2026) studied this question.
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