Malaria and Thrombocytopenia: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Thrombocytopenia is a frequently reported hematological abnormality in malaria. However, its precise prevalence, diagnostic utility, and prognostic value across different Plasmodium species remain inadequately synthesized. To determine the pooled prevalence of thrombocytopenia in malaria, its accuracy in diagnosing malaria in febrile patients, and its association with severe disease and mortality. A systematic search of MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception to May 2023. Observational studies (cohort, cross-sectional, case-control) reporting platelet counts or the prevalence of thrombocytopenia in patients with smear-positive or rapid diagnostic test (RDT)-confirmed malaria were included. Two independent reviewers extracted data on study characteristics, patient demographics, parasite species, platelet counts, and clinical outcomes. The quality of studies was assessed using the Newcastle-Ottawa Scale. 127 studies involving 98,451 malaria patients were included. The pooled prevalence of thrombocytopenia (platelet count <150,000/μL) was 74% (95% CI, 71-77%; I²=94%). Prevalence was high in both P. falciparum (72%, 95% CI 68-75%) and P. vivax (78%, 95% CI 74-81%) infections. The pooled mean platelet count was 89,500/μL (95% CI 85,200-93,800/μL). For diagnosing malaria in febrile patients, thrombocytopenia had a pooled sensitivity of 0.75 (95% CI 0.71-0.79), specificity of 0.81 (95% CI 0.77-0.84), and a diagnostic odds ratio of 14.2 (95% CI 10.5-19.1). Patients with severe thrombocytopenia (<50,000/μL) had a significantly higher risk of severe malaria (Pooled Relative Risk 3.45, 95% CI 2.68-4.44) and mortality (Pooled RR 2.91, 95% CI 1.98-4.27). Thrombocytopenia is a highly prevalent and salient feature of both P. falciparum and P. vivax malaria. It serves as a strong diagnostic marker for malaria in febrile illness and is a significant prognostic indicator for disease severity and mortality. Received Date: December 26, 2024 Accepted Date: January 12, 2024 Published Date: February 1, 2024 Available Online at https://www.ijsrisjournal.com/index.php/ojsfiles/article/view/485
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.025 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.020 | 0.032 |
| Bibliometrics | 0.007 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".