Haematological Profile and Mortality in Patients with Lassa Fever in Irrua Specialist Teaching Hospital, Irrua, Nigeria

Abstract

Background: The viral haemorrhagic fever Lassa fever endemic in West African countries including Nigeria and Sierra Leone is associated with haematological changes characterised by bleeding and dysfunctional platelet aggregation. Haematological parameters, such as full blood count are widely used clinical indicators of health and disease. These parameters may be deranged in patients with Lassa fever. Objective: The main objective of this study was to determine the haematology outcomes in patients with acute Lassa fever, and their relationships with the haemorrhagic manifestations. Methodology: This was a hospital-based case-control study involving 324 participants. Lassa positive patients, febrile Lassa negative patients (control group 1) and afebrile Lassa negative individuals (Control group 2) were recruited into the study. Full (complete) blood count parameters were determined using Orphee Mythic 22 auto analyzer (model number SN 510121-000086). Data generated were analyzed using the SPSS version 26 statistical software packages. Results: A total of 324 participants were recruited in this study, involving 108 Lassa positive patients as the test group, 108 age and sex matched non-Lassa febrile group as control 1 and 108 age and sex matched non-Lassa afebrile group as control 2. The mean PCV (%) was lower in Lassa subjects than in control, as well as the mean MCV (fl); the differences were statistically significant p=0.021 and p=0.022 respectively. Mean MPV (fl) was higher in the febrile group (Lassa and non-Lassa febrile) than in non-Lassa afebrile control (p= 0.016). Also, the mean PDW (%CV) was lower in Lassa subjects than in controls and the mean differences were statistically significant p<0.001. Mean Reticulocyte count (%) was higher in the Lassa group than the controls (p<0.001). Median Neutrophil count was lower in Lassa than in controls (p<0.001). However Median Lymphocyte count was higher in Lassa subjects than in controls (p<0.001). A total of 3.7% of the subjects had leucoerythroblastic blood picture. About 97.2% of the study population survived while 2.8% died. MPV showed a strong association with patient’s outcome (p=0.016) and 25% of those that had leucoerythroblastic blood picture died (p=0.006). In conclusion, this study has shown that MPV and leucoerythroblastic blood picture were strongly associated with mortality in Lassa fever patients.