Erythrocyte Indices and Leucocyte Count of Children with Plasmodium Falciparum Infection in Yola, Nigeria

Abbreviations: RDW: Red Cell Distribution Width; MCV: Mean Cell Volume; MCH: Mean Cell Hemoglobin; MCHC: Mean Cell Hemoglobin Concentration; RBC: Red Blood Cell; HCT: Hematocrit; WBC: White Blood Cell; RDW-CV: Red Cell Distribution Width Coefficient of Variation; Background/Objectives: Plasmodium falciparum malaria is the commonest cause of childhood mortality in Africa with varied hematology consequences hence, this study aims to evaluate erythrocyte indices of children with P. falciparum infection in other to elucidate infant’s erythrocyte condition during falciparum infection.


Introduction
Erythrocyte indices are parameters that examine red blood cell conditions and measures the size, shape, and physical characteristics of erythrocytes [1] and erythrocyte indices are usually part of routine automated full blood count test which measures our general health.
In pediatric medicine however, erythrocyte indices constitute important hematological parameters useful in clinical care of children [2] and erythrocyte indices are frequently overlooked in clinical practice but they provide assistance in establishing diagnosis in many health problems including: inflammatory [3] and anemic conditions [4]. Erythrocyte indices considered in this Human beings have an immune system that depends on different types of white blood cells for protection against diseases [5,6].
These white blood cells also called leucocytes include: Neutrophils, Lymphocytes, Monocytes, Basophils and Eosinophils. White blood cells are vital components of blood that help fight infection, foreign bodies and response to inflammatory and allergic processes. White Blood Cell (WBC) counts during malaria are generally characterized as being low or normal and WBC counts have been reported to be lower in patients infected with Plasmodium falciparum [7]. Plasmodium falciparum is a unicellular protozoan parasite of humans and human malaria are caused by any of several species of Plasmodium parasites that may occur together in various combinations in endemic regions. Plasmodium falciparum is responsible for almost all etiology and mortality attributed directly to malaria and P. falciparum is the focus of almost all research and interventional efforts [7] in sub-Saharan Africa. In Nigeria however, malaria parasitemia arising from plasmodium falciparum infection still remains a public health challenge [8] and malaria infection has a complex effect on physiology of erythrocyte as well as iron metabolism that may affect hemoglobin and serum ferritin and malaria is the commonest cause of childhood morbidity in Africa with varied hematology consequences [9] hence, this study aims to evaluate the erythrocyte indices and leucocyte count of children with P. falciparum infection in other to elucidate the general health condition of infant's erythrocyte and leucocyte during plasmodium falciparum infection.

Inclusion Criteria
Symptomatic and asymptomatic children less than 30months old in the hospital who had P. falciparum malaria infection with no hemoglobinopathy and other clinical diseases were recruited for this study.

Exclusion Criteria
Children more than 30months old who had hemoglobinopathies and other clinical disorders were excluded. In addition, children who were infected with other species of Plasmodium aside from falciparum were also excluded from this study.

Materials and Methods
This prospective and descriptive study was carried out at the  Table 3.     Table 3. falciparum in this study. The mean total red cell count of children with P. falciparum infection was 2.63±0.9x1012/l while that of the control group was 4.31±0.8x1012/l this shows that children with P. falciparum infection had a lower red cell count than the control group at P<0.05 and this is because anemia has been reported to be a consequence of P. falciparum infection [11]. The hematocrit level and hemoglobin level in subject was lower than that of the control group which could imply presence of asymptomatic anemia arising from imbalance between production and destruction of red blood cell in children with falciparum malaria [12]. In addition, the RDW of children with P. falciparum infection was 16.5±0.1% while the RDW for control group was 13.2±0.9% and this higher value of RDW among subjects is a pointer to presence of anisocytosis in this group of children because RDW is a measure of size variance of RBCs [13]. Therefore, a low RDW suggests uniform red cell size,

Discussion
whereas an elevated RDW (greater than 14 percent) as observed in this study indicates RBCs of variable and multiple sizes (i.e anisocytosis) therefore, the red cell of infants investigated were of variance sizes. The MCV of infected children was higher than that of the control group and this implies that the RBC infected with plasmodium falciparum was larger in size than non-infected RBC in this study. There were no significant differences between

Disclaimer
The views expressed in this article are that of the author(s) not an official position of any hospital or institution.

Financial Sponsorship
This study was not sponsored, the equipment used was provided by the hospital in which this work was done.