Evaluation of blood cell count parameters as predictors of treatment failure of malaria in Angola: An observational study

BACKGROUND: Despite the guidelines provided by the World Health Organization for the treatment of malaria, treatment failure occurs in many hospitalized patients. OBJECTIVE: Evaluate whether blood cell count parameters may serve as predictors for malaria treatment. METHODOLOGY: A cross-sectional study with a quantitative approach. RESULTS: Of the 219 patients, 21.5% showed failure to antimalarial treatment, Patient with 21 and 40 years (72.6%), male (53.4%), from peri-urban area (47.5%), with high parasitemia (59.8%), treated with Arthemeter (90.9%) and the mortality were 5.9%. Significant associations were observed between occupation, level of parasitemia and outcome with resistance to antimalarial treatment (p<0.05). Patients with normal Hb [OR: 0.75 (95% CI: 0.39-1.44), p = 0.393], RBC [OR: 0.83 (95% CI: 0.40-1.72), p = 0.632], RDW [OR: 0.54 (95% CI: 0.27-1.09), p = 0.088], MCV [OR: 0.61 (95% CI: 0.28-1.31), p = 0.204] were less likely to have malaria treatment failures after artemisinin-based therapy failure. In contrast, those with normal values of segmented neutrophils [OR: 0.32 (95% CI: 0.11-0.96), p = 0.042] and lymphocyte counts [OR: 0.24 (95% CI: 0.05-1.04), p = 0.055]. We also found that patients with significant low levels of Hct [OR: 0.31 (95% CI: 0.15-0.64) p = 0.002], and high leukocytes [OR: 8.88 (95% CI: 2.02-37.2), p = 0.004] and normal platelet values [OR: 1.42 (95% CI: 0.73-2.95), p = 0.280] demonstrated high probability of treatment failure. CONCLUSION: The importance of blood cell count parameters in monitoring malaria therapy necessitates the urgent need to re-evaluate Artemether-based therapy. Future studies involving more participants in different settings are needed to provide further evidence.