Hematological Abnormalities as Diagnostic Indicators of Malaria in Returning Travelers: A Retrospective Study at Mohamed V Military Instruction Hospital

Abstract

Introduction Malaria remains a significant global health concern, particularly in travelers returning from endemic regions. Hematological abnormalities are often associated with malaria and can serve as diagnostic indicators, especially when clinical symptoms are nonspecific. Objective This study aims to identify the most relevant hematological parameters for diagnosing malaria in travelers returning from endemic areas, who sought care at the Mohamed V Military Instruction Hospital in Rabat. Methods We conducted a retrospective comparative study involving 829 patients who returned from malaria-endemic regions between January 2017 and December 2023. Data collected included demographic information, parasitological test results, and comprehensive hematological profiles. Statistical analysis was performed to determine the sensitivity and specificity of various hematological parameters in diagnosing malaria. Results Thrombocytopenia, lymphocytopenia, and anemia were the most significant hematological abnormalities associated with malaria. Thrombocytopenia, defined as a platelet count below 150 x 103/µL, demonstrated a sensitivity of 75.91% and a specificity of 84.11%. Lymphocytopenia, with a threshold of less than 1.5 x 103/µL, showed a sensitivity of 69.47% and a specificity of 78.39%. Anemia, defined by hemoglobin levels below 13 g/dL in men and 12 g/dL in women, also significantly correlated with malaria diagnosis. Discussion This study highlights the significance of hematological abnormalities as key diagnostic markers for imported malaria cases. By analyzing retrospective data, we observed that these abnormalities, especially thrombocytopenia and anemia, are common among returning travelers with confirmed malaria. These findings suggest that clinicians can use such markers as a valuable tool for early malaria diagnosis, potentially improving patient outcomes. Additionally, the study reinforces the need for heightened awareness among healthcare providers in non-endemic regions regarding the presentation of malaria in travelers. Conclusion Hematological parameters such as thrombocytopenia, lymphocytopenia, and anemia are valuable diagnostic tools for malaria in returning travelers. These findings suggest that these parameters should be integrated into diagnostic protocols to improve the accuracy and timeliness of malaria diagnosis, particularly in clinical settings with limited access to advanced diagnostic tools.