ArticleBMC medicine2015
The clinical implications of thrombocytopenia in adults with severe falciparum malaria: a retrospective analysis.
Article in BMC medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Severe thrombocytopaenia in patients with vivax malaria compared to falciparum malaria: a systematic review and meta-analysis.Infectious diseases of poverty · 2018Pooled it
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- Atypical memory B cell clonal expansion and inflammatory programs associate with platelet-activating antibody development in COVID-19.JCI insight · 2026Article
- Clinical characteristics of thrombocytopenia in tropical diseases and management in resource-limited settings.Research and practice in thrombosis and haemostasis · 2026Review
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- Severe Malaria in Angola: The Clinical Profile and Disease Outcome Among Adults from a Low-Endemic Area.Biomedicines · 2024Article
- Basic coagulation parameters and platelet count among malaria patients attending at Addis Zemen Primary Hospital, Northwest Ethiopia.BMC infectious diseases · 2024Article
- A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review.BMC infectious diseases · 2023Review
- Investigating the association between various platelet indices and different clinical sub-groups of severe malaria.Malawi medical journal : the journal of Medical Association of Malawi · 2023Article
- Intravenous whole blood transfusion results in faster recovery of vascular integrity and increased survival in experimental cerebral malaria.Memorias do Instituto Oswaldo Cruz · 2023Article
- Severe malaria.Malaria journal · 2022Review
- Improving the diagnosis of severe malaria in African children using platelet counts and plasmaScience translational medicine · 2022Article
- Pancytopenia with severe thrombocytopenia in asymptomatic malaria in advanced pregnancy: a case report.The Pan African medical journal · 2022Article
- Acute Malaria in Malawian Children and Adults is Characterized by Thrombocytopenia That Normalizes in Convalescence.Journal of blood medicine · 2022Article
- Review
- Article
- Machine learning approaches classify clinical malaria outcomes based on haematological parameters.BMC medicine · 2020Article
- Platelet disturbances correlate with endothelial cell activation in uncomplicated Plasmodium vivax malaria.PLoS neglected tropical diseases · 2020Article
- Clinical features and haematological parameters among malaria patients in Mangaluru city area in the southwestern coastal region of India.Parasitology research · 2020Article
- Increased platelet distribution width and reduced IL-2 and IL-12 are associated with thrombocytopenia in Plasmodium vivax malaria.Memorias do Instituto Oswaldo Cruz · 2020Article
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Authors and funding
16 authors at 7 institutions in 5 countries.
Funding
Abstract
backgroundThrombocytopenia is a common finding in adults with severe falciparum malaria, but its clinical and prognostic utility is incompletely defined.
methodsClinical and laboratory data from 647 adults with severe falciparum malaria were analysed retrospectively to determine the relationship between a patient's platelet count on admission to hospital and their subsequent clinical course.
resultsOn admission, 614 patients (94.9%) were thrombocytopenic (platelet count <150 × 10(9)/L) and 328 (50.7%) had a platelet count <50 × 10(9)/L. The admission platelet count was inversely correlated with parasite biomass (estimated from plasma PfHRP2 concentrations, rs = -0.28, P = 0.003), the degree of microvascular sequestration (measured with orthogonal polarizing spectral imaging, rs = -0.31, P = 0.001) and disease severity (the number of World Health Organization severity criteria satisfied by the patient, rs = -0.21, P <0.001). Platelet counts were lower on admission in the patients who died (median: 30 (interquartile range 22 to 52) × 10(9)/L versus 50 (34 to 78) × 10(9)/L in survivors; P <0.001), but did not predict outcome independently from other established laboratory and clinical prognostic indices. The 39 patients (6%) with profound thrombocytopenia (platelet count <20 × 10(9)/L) were more likely to die (odds ratio: 5.00, 95% confidence interval: 2.56 to 9.75) than patients with higher platelet counts, but these high-risk patients could be identified more rapidly with simple bedside clinical assessment. The admission platelet count did not reliably identify the 50 patients (7.7%) with major bleeding during the study.
conclusionsThrombocytopenia is a marker of disease severity in adults with falciparum malaria, but has limited utility in prognostication, triage and management.
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