Objectives. To evaluate the predictive value of thrombocytopenia in malaria. Patients and Methods. It was a prospective observational study on all febrile patients with thrombocytopenia presenting to the Medical Unit of Hayat Abad Medical Complex during November 2008 to November 2010. Results. Of the total of 228 patients with fever and thrombocytopenia, 121 patients (53%) proved to be suffering from malaria. Of them 82 patients (68%) had falciparum malaria while 39 patients (32%) had vivax infection. Of these 121 patients, platelet counts ranged between 25,000 and 150,000/dL with a mean value of 101,000/dL ( S D ± 4 7 , 5 0 0 ) and a median of 75,000/dL. Of the 107 patients who were not suffering from malaria, the counts ranged between 10,000 and 150,000/dL with a mean value of 58,000/dL ( S D ± 5 4 , 0 0 0 ) and median of 50,000/dL. Conclusions. The presence of thrombocytopenia may be a predictor of malaria in adult population. 1. Introduction Malaria is commonly associated with various degrees of hematological complications like anemia and thrombocytopenia. The anemia is usually due to varied reasons ranging from hemolysis to comorbidities like parasitic infections, folate, iron, and vitamin B12 deficiencies in endemic areas, antimalarials and further complicated by the coexistence of thalassemia and other haemoglobinopathies [1]. Anemia and thrombocytopenia are the most frequent malaria-associated hematological complications [2]. The hematopoietic response is, however, also somewhat blunted, and there is reduced platelet count and sometimes reduced WBC counts as well. Thrombocytopenia is a very common association of malaria. In the past it was thought that malaria is rarely associated with clinical features of thrombocytopenia like bleeding disorders and is usually an incidental finding on blood testing. Recent scientific evidences have invalidated this anecdote. It is pertinent that the finding of thrombocytopenia in patient may be an indication for a thorough lookout into the blood smear to rule out malaria as the cause. This fact is especially important in the workup for thrombocytopenia in febrile patients. Thrombocytopenia may be associated with bleeding tendency which is one of the important severe manifestations of P. falciparum malaria. The presence of thrombocytopenia in acute febrile travelers returning from tropical areas has become a highly sensitive clinical marker for malaria diagnosis [3]. A number of observational studies have confirmed the association of thrombocytopenia to malaria but till date the cause of thrombocytopenia is
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