EVALUATION OF SOME HEMATOLOGICAL PARAMETERS AND BILIRUBIN IN MALARIA-INFECTED ADULTS ATTENDING FEDERAL UNIVERSITY TEACHING HOSPITAL, OWERRI, NIGERIA

Background: Malaria is a disease caused by a parasite called Plasmodium, which is transmitted by the bite of infected female anopheles mosquito. Plasmodium is a hemiparasite that affects red blood cells leading to their destruction (Hemolysis). In malaria disease, there is an increased bilirubin levels due to hemoglobin breakdown, decreased red blood cell count due to hemolysis and increased erythrocyte sedimentation rate value due to inflammation. Aim: This study was aimed at evaluating the effects of malaria parasitemia on erythrocyte sedimentation rate (ESR), red blood cell count (RBC), and bilirubin levels in affected adults attending federal university teaching hospital, Owerri, Nigeria. Method: A total of 90 subjects were recruited for the study. 50 were patients infected with malaria parasitemia, while 40 age - matched healthy subjects served as controls. Seven (7) milliliters of venous blood sample was collected at the antecubital vein aseptically. 2ml was dispensed into ethylenediaminetetraacetic acid containers for RBC estimation, 2ml was dispensed into sodium citrate bottles for ESR determination, while 3ml was dispensed into plain containers for bilirubin estimation. The EDTA, sodium citrate and plain containers were properly labeled with the subjects’ names, sample numbers and date of collection. The blood dispensed into the EDTA, sodium citrate containers, were stored in a refrigerator at -4oC while the serum was stored in a freezer at - 200C prior to use. ESR was analyzed using Westergren method, RBC count using hematology analyzer, and Bilirubin was analyzed using Jendrassik Grof's method. The procedure was carried out at the Federal University Teaching Hospital in Owerri. Results: The results of the tests were analyzed using SPSS version. The mean values of ESR (14.51±5.79) mm/hr, total bilirubin (1.15±0.35) mg/dl, conjugated bilirubin (0.19±0.08) mg/dl and unconjugated bilirubin (0.93±0.25) mg/dl were significantly increased in patients with malaria infection when compared to controls (7.7±5.79) mg/dl,(0.68±0.22) mg/dl, (0.15±0.06) mg/dl and (0.53±0.17) mg/dl (p=0.000, p=0.000, p=0.018 and p=0.000). The mean value of RBC (3.99±0.27) x10 12/L was significantly reduced in adult patients with malaria infection when compared to controls (4.56±0.47) x1012/L (p=0.000). There was a significant positive correlation (r=0.38, p=0.007) of total bilirubin with ESR in adult patients with malaria infection. There was a significant negative correlation of total bilirubin with RBC in adult patients with malaria infection (r=-0.65, p=0.000). Conclusion: This study showed that levels of ESR, RBC count and bilirubin in malaria-infected adults are altered. Therefore, there is need to monitor these parameters in malaria infection to avoid complications. The results of these tests can help to determine the severity of the infection and to identify patients who are at risk for complications or death. Early identification of patients at high risk is essential for ensuring timely and appropriate treatment, which can improve outcomes and reduce mortality.