Platelet counts at Kamuzu Central Hospital in Lilongwe, Malawi.

Abstract

It is not clear as to what the prevalence of quantitative abnormalities of platelets is in Malawian hospitals as full blood counts are not routinely available.

Both thrombocytosis and thrombocytopenia may be fatal. We therefore carried out a retrospective  analysis of platelet counts of 1,297 randomly selected case notes of in-patients presenting to Kamuzu Central Hospital (KCH) in Lilongwe in the period 2005-2009. Platelet counts were graded into unknown, normal, mild thrombocytopenia, moderate thrombocytopenia, severe thrombocytopenia and increased counts.

The overall prevalence of thrombocytopenia was found to be 26% and that of thrombocytosis to be 5% but a relatively high percentage of patients (36%) had unknown platelet counts. Malaria patients formed the highest percentage of those with severe thrombocytopenia followed by sepsis then tuberculosis, pneumonia, epistaxis, anaemia, bleeding, and Kaposi's sarcoma.  Among the study patients who died, those with severe thrombocytopenia were the highest percentage (25.8%) compared to all the other platelet count grades. A prospective study is required to assess the cost effectiveness of not doing routine full blood counts. Not obtaining routine platelet counts might be contributing to mortality in our patient population.