Abstract:
To determine the diagnostic efficacy of Giemsa stained thick smear of bone marrow aspirate for evidence of malaria in febrile individuals in whom the diagnosis was otherwise unknown. This study was conducted at the Department of Medicine, Sandeman Provincial Hospital, Quetta, in the Balochistan province of Pakistan, between January 1994 and December 1998. A total of 80 patients were included in the study, who presented with history of fever for more than 3 weeks with splenomegaly and pancytopenia. The bone marrow specimens of all these patients were examined. The bone marrow was aspirated from the posterior superior iliac spine. Three sets of smears were made. One set of thin smears was stained by leishman’s stain after air-drying and the second set of thin smears was sir-dried, fixed with 97% methanol and later stain with 5% Giemsa stain. The third set of smears was a thick smear stained unfixed with 5% Giemsa stain. A temperature of 37°C and a pH of 7.2 was maintained during the staining process. The peresence of malarial parasite in the bone marrow was determine. Beside, the degree of megaloblastic change in erythroid series and the bone marrow cellularity were evaluated. The results obtained were recorded and statistically analyzed. Of the 80 bone marrows examined, 32(40%) showed the presence of malarial parasites, 19 (23.75%) showed haematological malignancies, 16(20%) showed bone marrow suppression while 12(15%) showed megaloblastic change. One (1.25%) case showed Leishman-Donovan, i.e. Plasmodium falciparum ganetocytest on thin smear while 32(100%) cases showed plasmodium falciparum trophozoites and gametocytes on thick smear. The ratio was 1:6.4. These 32 patients were divided into two groups, one group one having mild anaemia (>8g/dl) and the other severe anaemia (Hb
Page(s):
577-580
DOI:
DOI not available
Published:
Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 13, Issue: 10, Year: 2003