Exploring Biochemical and Hematological Variations in Malaria Cases: A Retrospective Analysis at a Health Center at Mumbai City India

Abstract

Introduction: In Mumbai, an overpopulated metropolis with tropical conditions, malaria poses a persistent challenge, particularly in damp slum areas. Despite reported declines in death and incidence rates, the city faces a significant burden. Our project focuses on an unusual aspect: a heightened incidence among males, especially during sporadic monsoon outbreaks and in areas undergoing extensive redevelopment. Through an epidemiological survey of infected populations in municipal clinics, supported by microscopic, hematological, and microbiological evidence, we aim to provide insights into this atypical pattern. Materials and Methods: A cross-sectional, partly retrospective study was designed with participants being sourced from regional slums and chawls, during the immediately preceding three-year period of project completion. Patients attending OPDs were randomly selected from amongst those with febrile symptoms related to malarial disease and tested. Symptomatic individuals were tested for malaria microscopically using peripheral blood smear (PBS) and confirmed by employing the malaria antigen test (RMAT). Blood urea by enzymatic method and serum creatinine by Jaffes method. Results: Out of 1651 participants, 8.18% were malaria-positive, predominantly males (87.41%). P. vivax was the main parasite (87.41%), followed by P. falciparum (6.67%) and mixed infections (5.93%). ANOVA revealed significant RBC count differences (F = 6.32, p = 0.003). Tukey's HSD test showed P. vivax patients had higher RBC counts than mixed infection (p = 0.002), while P. falciparum counts were similar to P. vivax (p = 0.089) but higher than mixed infection (p = 0.014). Predominance of P. vivax emphasizes its impact on RBC counts and diagnostic complexities. The p values indicate that for all parameters, except serum creatinine in males, there is a statistically significant difference in the mean values between the malaria positive and negative groups Conclusion: This study highlights high malaria prevalence in urban India, with males more susceptible, possibly due to increased mosquito exposure. P. vivax is predominant, aligning with national data, emphasizing the need for tailored control measures. Surprisingly, P. vivax is associated with higher RBC counts than P. falciparum or mixed infection, suggesting differences in erythrocytic cycles. These findings have critical implications for regional malaria management, prompting further research into underlying mechanisms.