REFRACTORY ANEMIA AND PANCYTOPENIA AS PRESENTATIONS OF FALCIPARUM MALARIA IN POPULATION OF KHYBER PAKHTUNKHWA, PAKISTAN.

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    • Subject Terms:
      KHYBER Pakhtunkhwa (Pakistan); PESHAWAR (Pakistan)
    • Abstract:
      Background: Falciparum malaria is not an uncommon infection in population of Khyber Pakhtunkhwa, Pakistan. Apart from its classical presentation, it may present with refractory anemia or pancytopenia. The objective of this study was to determine frequency of refractory anemia and pancytopenia as presentations of falciparum malaria in population of Khyber Pakhtunkhwa, Pakistan. Material & Methods: This descriptive study was conducted at the Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan, over the years 2011 to 2014. A detailed history, clinical examination, and pertinent laboratory tests were performed for a sample of 200 cases of falciparum malaria. All patients were treated with antimalarial drugs and followed-up for eight weeks. Results: Out of 200 patients with falciparum malaria, 85 (42.5%) were males and 115 (57.5%) females. The age ranged from 15 to 55 years. Out of these 200 patients, frequency of refractory anemia was 175 (87.5%) and frequency of pancytopenia was 25 (12.5%). Among 175 cases, 125 (71.43%) were smear positive for P. falciparum and 50 (28.57%) were positive on rapid antigen tests (RATs). In 25 (12.5%) patients with pancytopenia, the smear for malaria and RATs were positive only in 5 (20%) patients. In remaining 20 (80%) cases, bone marrow examination revealed P. falciparum in all cases. All patients dramatically responded to treatment with antimalarials and supportive care including hematinics. Conclusion: Plasmodium falciparum should be considered in cases of prolonged fever with refractory anemia or pancytopenia in the malaria endemic areas, even with negative smear and rapid antigen tests. Bone marrow examination is mandatory for diagnosis in such cases. [ABSTRACT FROM AUTHOR]
    • Abstract:
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