Intraleucocytic hemozoine as an indicator of malaria complicated by Plasmodium falciparum

Abstract

Objective: To establish the relationship between the presence and number of hemozoinecontaining leukocytes and severe malaria.

Design: a cross sectional study.

Individuals: 183 individuals divided into four groups: 25 healthy individuals, 6 hospitalized patients with hemolytic disorders, 25 hospitalized patients with diagnosis other than malaria or hemolytic disease and 127 Plasmodium falciparum malaria patients (64 uncomplicated and 63 complicated).

Tests: the number of hemozoin-containing neutrophils and hemozoin-containing mononuclear cells In peripheral blood thin Smears was assessed by light microscopy. A total of 100 neutrophils cells and 60 mononuclear cells were reviewed in each thin smear.

Results: 35% (44/127) malarial patients had hemozoin-containing leukocytes and 25% (32/127) had hemozoin-containing neutrophils. A significant association was observed between severe malaria and the presence of these cells. Similarly, a positive lineal correlation between number of hemozoin-containing neutrophils and parasitaemia (r=0.57; p<0.05) was observed. No association was observed between presence of hemozoin-containing mononuclears and severe malaria. Hemozoincontaining leukocytes were absent in non malaria patients.

Conclusions: Although only 35% patients have hemozoin-containing leukocytes, a strong association between complicated malaria and presence of hemozoin-containing neutrophils is evident. These findings suggest that the presence of these cells might constitute a warning sign and, therefore, careful evaluation of the patient is required is such cases