Background: Malaria is a significant health problem in India, being one of the biggest burdens in terms of morbidity and mortality. The mortality rate is high in severe malaria (10-30%), and hematological changes play a crucial role in morbidity and mortality. Monocytes, neutrophils, and lymphocytes play a vital role in the induction of immune responses to malaria infection and their parameters have been proven as predictors of malaria infection and its clinical severity. Materials and Methodology: This study was done for a period of 2 years i.e., from October 2017 to September2019, in the Department of Pathology, Andhra medical college, Visakhapatnam, during which 107 smear positive cases and 100 controls were studied. In suspected malaria cases Peripheral smear, Thick & Thin Smear & Rapid diagnostic test was done. Rest of the sample was subjected to SYSMEX 5-PART-Hematologyanalyzer to determine the Monocyte to Lymphocyte Count Ratio (MLCR), Monocyte to Neutrophil Count Ratio (MNCR) and Neutrophil to Lymphocyte Count Ratio (NLCR). Results: Out of 107 smear positive cases, P. vivax is the most common species causing Malaria. 35 cases had severe Malaria with more cases attributed to P. falciparum followed by P. vivax infections. Severe anaemia is seen in 33 cases (30.84%) in which P. falciparum association is predominant. Moderate thrombocytopenia is the most common presentation. Severity of anaemia and thrombocytopenia correlated with parasitemia. Among leucocyte count ratios – there is significant correlation between Monocyte to Lymphocyte Count Ratio (MLCR) and parasitemia. Conclusion: The grade of anaemia and thrombocytopenia increases with the severity of malaria especially in P. falciparum infection. MLCR (Monocyte Lymphocyte Count Ratio) can be used as a screening tool/biomarker along with clinical and other haematological parameters to predict the severity of malaria.

Background: Malaria is a significant health problem in India, being one of the biggest burdens in terms of morbidity and mortality. The mortality rate is high in severe malaria (10-30%), and hematological changes play a crucial role in morbidity and mortality. Monocytes, neutrophils, and lymphocytes play a vital role in the induction of immune responses to malaria infection and their parameters have been proven as predictors of malaria infection and its clinical severity. Materials and Methodology: This study was done for a period of 2 years i.e., from October 2017 to September2019, in the Department of Pathology, Andhra medical college, Visakhapatnam, during which 107 smear positive cases and 100 controls were studied. In suspected malaria cases Peripheral smear, Thick & Thin Smear & Rapid diagnostic test was done. Rest of the sample was subjected to SYSMEX 5-PART-Hematologyanalyzer to determine the Monocyte to Lymphocyte Count Ratio (MLCR), Monocyte to Neutrophil Count Ratio (MNCR) and Neutrophil to Lymphocyte Count Ratio (NLCR). Results: Out of 107 smear positive cases, P. vivax is the most common species causing Malaria. 35 cases had severe Malaria with more cases attributed to P. falciparum followed by P. vivax infections. Severe anaemia is seen in 33 cases (30.84%) in which P. falciparum association is predominant. Moderate thrombocytopenia is the most common presentation. Severity of anaemia and thrombocytopenia correlated with parasitemia. Among leucocyte count ratios – there is significant correlation between Monocyte to Lymphocyte Count Ratio (MLCR) and parasitemia. Conclusion: The grade of anaemia and thrombocytopenia increases with the severity of malaria especially in P. falciparum infection. MLCR (Monocyte Lymphocyte Count Ratio) can be used as a screening tool/biomarker along with clinical and other haematological parameters to predict the severity of malaria.