Morphological classification of anaemia and neutrophil patterns in pregnant women with asymptomatic malaria parasite infection

Abstract

Asymptomatic Plasmodium infection during pregnancy increases the risk of stillbirths, abortion, premature delivery, and low birth weight. It also hinders the control and prevention of malaria as infected hosts serve as silent reservoirs for the transmission of Plasmodium species in the community. This study was conducted to assess the morphological classification of anaemia and neutrophil patterns in asymptomatic malaria parasite-infected pregnant women in Calabar, Nigeria. Fifty pregnant women attending the Antenatal Clinic at the University of Calabar Teaching Hospital in Nigeria, and 50 age-matched non-pregnant women were recruited for the study. The red cell indices and neutrophil lymphocyte ratio (NLR) were determined using Mindray assay automated haematology analyser, while standard microscopy technique was used to detect malaria parasites. The MCV (79.93 ± 9.18fl) was significantly (p<0.05) higher in pregnant women with asymptomatic malaria parasite infection compared to the non-pregnant women (73.04 ± 4.10fl), while their MCH (26.54 ± 2.17pg) was seen to be significantly lower than the non-pregnant women (28.61 ± 1.67). The NLR value in this study was seen to be significantly (2.10 ± 0.76) higher in pregnant women than non-pregnant women (1.22 ± 0.51). The prevalence of anaemia amongst the pregnant women was 48% and normocytic normochromic anaemia (54.2%) was found to be the most prevalent form of anaemia in the pregnant women, followed by microcytic hypochromic anaemia (41.7%) and then macrocytic normochromic anaemia (4.1%). Pregnant women were more susceptible to the parasite, especially Plasmodium falciparum, with a mean parasite density of 692.16 ± 151.95 (parasite/μl). A strong negative correlation was seen between the malaria parasite density and the haematocrits of the pregnant women with asymptomatic malaria parasite infection. Malaria parasite density and NLR were seen to be significantly higher in pregnant women with asymptomatic malaria infection, and normocytic normochromic anaemia was the most prevalent form of anaemia.