Coagulation status and platelet functions in children with severe falciparum malaria and their correlation of outcome.

This study was undertaken to observe the changes in coagulation and platelet profile, and findings were correlated with their outcome. Forty consecutive children with severe falciparum malaria were studied for their coagulation status, i.e. prothrombin time (PT), activated thromboplastin time (APTT), thrombin time (TT) and anti-thrombin-III (AT-III), platelet profile (platelet count, platelet aggregation with adenine diphosphate (ADP) and ADR and PF3 availability). Derangements in the coagulation profile in the form of increased PT, APTT and/or TT were seen in 47.5, 35 and 62.5% cases, respectively, but bleeding was seen in only six cases. Thrombocytopenia was found in 34 patients. Platelet aggregation with ADP and ADR revealed hypoaggregation in 95.3 and 97.5% cases, respectively, and were statistically significant. Platelet factor-3 availability was also significantly prolonged. Patients with prolonged PT, PF-3 and hypoaggregation with adrenaline had 1.4, 1.7 and 1.45 times higher risk of mortality.