Blood Cell Count Changes and Haemoglobin Genotypes in Children with Malaria and Bacteraemia in Siaya County Referral Hospital, Kenya

Abstract

Malaria and bacteraemia co-infection in children, normally produce changes in blood cellular components. Full blood count results from children whose haemoglobin genotypes and bacteraemia is not known can greatly influence the reporting of the cellular components results from automated cell counter and this formed the aim of the on the clinical management and interpretation of the results. Nevertheless, there was missing information on the role of malaria and bacteraemia co-infection on cellular components of normal haemoglobin and sickle cell trait in children. A total number of 384 children were recruited and complete blood count test were analyzed by automated cell counter machine. Other tests done included malaria smear microscopy, blood culture by Bactec 9050 machine and haemoglobin genotype determined by Helena Haemoglobin electrophoresis method. Children were stratified into two study groups; Malaria positive and bacteraemia negative and malaria positive and bavteraemia positive. Across groups analysis against region established normal ranges, showed lymphocytopnia and thrombocytopenia. Bacteria isolated were all from children with Hb genotype AS with malaria and bacteraemia co-infection with bacteraemia prevalence of 8.1% (31,of 384). The isolated bacteria species included non-typhi salmonella (NTS) (32%), Escherichia coli (3%) Enterobacter cloacae (6.5%), Staphylococcus aureus (39), Listeria monocytogenes (10%), Streptococcus pyogenes (3%) and viridans streptococci (6.5%). Obtained results indicated that salmonella species and staphylococcus aureus bacteria as the most prevalent isolates associated with bacteraemia in children with haemoglobin genotype AS with malaria infection. Haemoglobin genotypes AS children are seen to be prone to malaria and bacteraemia co-infection and lymphocytopenia and thrombocytopenia being the common cellular changes seen in full blood count results. Staphylococcus aureus and salmonella spp were the most prevalent bacterial isolates. Recommended that haemoglobin electrophoresis should be considered for all paediatric patients admitted with malaria and bacteraemia co-infection with complete blood count indicating lymphocytopenia.