Haematological Profiles of Malarial Patients with and Without Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency in Mardan, Khyber Pakhtunkhwa, Pakistan

Abstract

Malaria, caused by protozoan parasites of the genus Plasmodium (family Plasmodiidae, phylum Apicomplexa), remains a significant global health challenge. This study investigated the haematological profiles and prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in malaria patients infected with Plasmodium vivax in Mardan, Pakistan. Blood samples were collected from 104 malaria-positive patients seeking treatment at local hospitals, with informed written consent obtained from all participants or their guardians (for minors). Malaria was diagnosed via standard microscopic examination of Giemsa-stained blood films, and all samples were tested for G6PD deficiency. Haematological parameters, including hemoglobin, hematocrit, red blood cells (RBCs), white blood cells (WBCs), platelets, neutrophils, eosinophils, monocytes, lymphocytes, mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration (MCHC), were assessed using a complete blood count (CBC) performed on a hematology analyzer. Data were analyzed using Pearson correlation and Chi-square tests to evaluate associations between malaria infection, haematological parameters, and G6PD activity. Of the 104 cases, 56 (53.8%) were male and 48 (46.2%) were female, with G6PD deficiency identified in 4 (3.8%) patients (3 males, 1 female). Haematological abnormalities included anemia (65%), thrombocytopenia (59.6%), leukopenia or leukocytosis (30.8%), and variations in MCV and MCH. Significant positive correlations were observed between hemoglobin and hematocrit, MCHC and hemoglobin, and lymphocytes and WBCs, while negative correlations were noted between RBCs and hematocrit, eosinophils and RBCs, and eosinophils and MCV. In G6PD-deficient patients, hemoglobin, WBCs, RBCs, platelets, MCV, and lymphocytes were consistently affected, with monocytes, eosinophils, and hematocrit altered in some cases. No significant correlations were found for age, platelets, hematocrit, neutrophils, WBCs, RBCs, MCV, MCHC, or lymphocytes among malaria patients, but hemoglobin showed significant variation in relation to G6PD deficiency. These findings confirm the prevalence of P. vivax malaria in Mardan and highlight its impact on haematological parameters, particularly in G6PD-deficient individuals. Further studies are warranted to explore the therapeutic implications of the association between G6PD deficiency and altered hemoglobin levels in malaria.