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This study examines hematologic profiles of persons with acute Plasmodium falciparum or P. vivax infection in Maesod on Thailand’s western border with Myanmar compared with febrile, non-parasitemic persons also reporting to malaria clinics. Nine hundred seventy-nine subjects were malaria-negative, 414 were infected with P. falciparum, and 646 were infected with P. vivax. Persons with patent parasitemia tended to have significantly lower white blood cell, red blood cell, platelet, and hemoglobin levels than those who were malaria-negative. For the first time, a parallel trend in thrombocytopenia with parasitemia was found to be associated with both P. falciparum, and P. vivax infection. Using logistic regression, persons with platelet counts < 150,000/µL were 12–15 times more likely to have malaria than persons with platelet counts 
150,000/µL. This study supplements previous literature on the hematologic effects of malaria and helps define those alterations for a semi-immune population. Thrombocytopenia is identified as a key indicator of malaria in these febrile patients.
Received July 11, 2003. Accepted for publication September 20, 2003.
Acknowledgments: This work was presented at the 51st Annual Meeting of the American Society of Tropical Medicine and Hygiene (Denver, CO) on November 12, 2002 by Laura M. Erhart (Abstract No. 242, Scientific Session J, Malaria Epidemiology and Diagnosis). We thank Dr. J. Sirichaisinthop for his support, and to the Malaria Field Team of the Department of Immunology of the Armed Forces Research Institute of Medical Sciences for technical assistance.
Financial support: This study was supported by U.S. Army Medical Materiel Development Activity (Fort Detrick, Frederick, MD).
Disclaimer: The opinions or assertions contained herein are those of the authors and should not be construed as reflecting the official positions of the U.S. Army, U.S. Air Force, or U.S. Department of Defense.
Authors’ addresses: Laura M. Erhart, Department of Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok 10400, Thailand, and University of Michigan School of Public Health, Ann Arbor, MI 48109-2029. Kritsanai Yingyuen, Niphon Chuanak, Nilawan Buathong, Anintita Laoboonchai, and R. Scott Miller, Department of Immunology and Medicine, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok 10400, Thailand. Chansuda Wongsrichanalai, U.S. Naval Medical Research Unit No. 2, Kompleks P2M/PLP-LITBANGKES, Jalan Percetakan Negara No. 29, Jakarta 10570, Indonesia, Telephone: 62-21-421-4457 extension 1121, Fax: 62-21-420-7854. E-mail: chansuda{at}namru2.med.navy.mil. Steven R. Meshnick, University of North Carolina School of Public Health, Chapel Hill, NC 27599-7435. Robert A. Gasser Jr., Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
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