Hemolytic anemia in falciparum and vivax malarial patients based on serum bilirubin examination

Main Article Content

Yoyoh Yusroh
Bidasari Lubis
Syahril Pasaribu
Munar Lubis
Tiangsa Sembiring
Adillida Adillida

Abstract

Objective To examine hemolysis in falciparum and vivax malarial
patients based on serum bilirubin examination.
Methods A cross sectional study was conducted on children
younger than 15 years of age who visited public health center in
the district of Mandailing Natal with complaints of fever, shivering,
pale, jaundice, diarrhea, or headache between April 9 th and April
19 th 2001. Variables recorded were age, gender, body weight, body
height, symptoms and signs, anti malarial drugs, and laboratory
test results. Thin and thick blood smears were done as diagnostic
tools of malaria. Thin blood smear was also performed to deter-
mine the level of malaria parasites in blood (parasitemia) and to
examine the morphology of red blood cells. Hemolysis was deter-
mined by bilirubin examination.
Results In P. falciparum malaria, there was a moderate correlation
(r=0.68, p<0.0001) between parasitemia and indirect bilirubin con-
centration. While in P. vivax malaria, there was only a weak corre-
lation (r=0.46, p=0.007) between parasitemia and indirect bilirubin
concentration. It was also found that in falciparum malaria, para-
sitemia, total and indirect bilirubin concentrations were significantly
higher than that in vivax malaria, with p values of 0.009, 0.015 and
0.003, respectively.
Conclusion Hemolysis in falciparum malaria is more severe than
that in P. vivax malaria, with marked elevation of indirect bilirubin.
The elevation of serum bilirubin correlated with parasitemia

Article Details

How to Cite
1.
Yusroh Y, Lubis B, Pasaribu S, Lubis M, Sembiring T, Adillida A. Hemolytic anemia in falciparum and vivax malarial patients based on serum bilirubin examination. PI [Internet]. 10Oct.2016 [cited 19Jul.2019];44(3):95-00. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/743
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Articles
Author Biographies

Yoyoh Yusroh

Department of Child Health, Medical School, University of
Sumatera Utara, Adam Malik Hospital, Medan

Bidasari Lubis

Department of Child Health, Medical School, University of
Sumatera Utara, Adam Malik Hospital, Medan

Syahril Pasaribu

Department of Child Health, Medical School, University of
Sumatera Utara, Adam Malik Hospital, Medan

Munar Lubis

Department of Child Health, Medical School, University of
Sumatera Utara, Adam Malik Hospital, Medan

Tiangsa Sembiring

Department of Child Health, Medical School, University of
Sumatera Utara, Adam Malik Hospital, Medan

Adillida Adillida

Department of Child Health, Medical School, University of
Sumatera Utara, Adam Malik Hospital, Medan
Received 2016-09-29
Accepted 2016-09-29
Published 2016-10-10

References

1. Oemijati. Masalah malaria di Indonesia. In: Pribadi W,
Muljono R and Sutanto I, editors. Kumpulan makalah
simposium malaria. Jakarta: PB FKUI; 1991. p. 1-8.
2. Rampengan TH. Malaria. In: Rampengan TH and
Laurentz IR, editors. Penyakit infeksi tropik pada anak.
Jakarta: EGC; 1990. p. 185-204.
3. Krause J. Malaria (Plasmodium). In: Behrman RE, Kliegman
RM, Jenson HB, editors. Nelson textbook of pediatrics.
16 th ed. Philadelphia: Saunders; 2000. p. 1049-52.
4. Tambajong EH. Patobiologi malaria. In: Harijanto
PN, editor. Malaria: epidemiologi, patogenesis,
manifestasi klinis dan penanganan. Jakarta: EGC;
2000. p. 249-77.
5. Siregar M. Epidemiologi malaria. Symposium on
Recent Advances on Malaria; 1994 Dec 6; Medan,
Indonesia.
6. Kakkilaya BS. Malaria-clinical features and manage-
ment. Available from: URL: http://www.geocities.com/
HotSprings/resort/5403/htm.
7. Madiyono B, Moeslichan S, Sastroasmoro S, Budiman
I, Purwanto SH. Perkiraan besar sampel. In:
Sastroasmoro S and Ismael S, editors. Dasar-dasar
metodologi penelitian klinis. Jakarta: BIKA FKUI; 1995.
p. 187-217.
8. Albar H, Agustina IS, Hangewa P, Syamsiah I. Malaria
pada anak di RSU Ternate. Cermin Dunia Kedokteran
1994;96:28-30.
9. Harianto PN. Manifestasi klinik, komplikasi, dan diag-
nosis malaria. Medika 1993;9:31-8.
10. Segel GB. Hemolytic anemias. In: Behrman RE,
Kliegman RM, Jenson HB, editors. Nelson textbook of
pediatrics. 16 th ed. Philadelphia: Saunders; 2000. p.
1472-93.
11. Balistreri WF. Manifestation of liver disease. In:
Behrman RE, Kliegman RM, Jenson HB, editors.
Nelson textbook of pediatrics. 16 th ed. Philadelphia:
Saunders; 2000. p. 1198-203.