The Value of Red Blood Cell Indices in the Diagnosis of Severe Malaria at a Tertiary Hospital in North-Eastern Nigeria

Aim: This study aimed at evaluating the red cell indices of children seen at the Federal Medical Centre, Azare, Nigeria, with a view to determining their utility in the diagnosis of severe malaria.

Study Design: The study was a case control study.

Place and Duration of the study: The study was conducted at the department of Paediatrics, Federal Medical Centre, Azare, Bauchi state, Nigeria from 1st August to 31st October, 2013.

Methodology: One hundred and ninety-six children aged 6 months to 12 years, comprising of 98 diagnosed with severe malaria and 98 controls were recruited into the study. The control subjects (with no clinical features of severe malaria) were recruited from the paediatric out patients unit (POPD). The following red cell indices were obtained from the subjects; haematocrit (HCT), haemoglobin concentration (HB), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC). The data was analysed using SPSS version 16.0. Diagnostic precision was determined by calculating sensitivities, specificities, positive predictive and negative predictive values. The accuracy of these figures was assessed using 95% confidence interval.

Results: The HCT had a sensitivity of 79.59% and a specificity of 80.65%, while the HB had a sensitivity of 81.63% and a specificity of 71.15%. The positive predictive values for HCT and HB were 86.67% and 84.21% respectively. MCV (59.04%), MCH (0.00%) and MCHC (0.00%) had low values. MCH and MCHC however had a significant relationship with severe malaria (P˂ .001).

Conclusion: In the presence of supporting clinical evidence, the existence of anaemia in a child in Azare would be a valuable supporting criterion in the diagnosis of severe malaria.