Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa

Enoch Boadi; Max Efui Annani-Akollor; Christopher Nkrumah; Ellis Kobina Paintsil; Anthony Eric Eshun; Lydia Omari; Yaw Frimpong; Egote Alexander Kofi

doi:doi:10.11648/j.ajlm.20261101.11

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Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa

Enoch Boadi^*

, Max Efui Annani-Akollor, Christopher Nkrumah

, Ellis Kobina Paintsil

, Anthony Eric Eshun, Lydia Omari, Yaw Frimpong, Egote Alexander Kofi

Published in American Journal of Laboratory Medicine (Volume 11, Issue 1)

Received: 3 November 2025 Accepted: 18 November 2025 Published: 16 January 2026

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Abstract

Malaria is classified as either uncomplicated (UM) or severe (SM), but the mechanism underlying the progression from uncomplicated to severe is still unclear. This study aimed to assess haematologic and biochemical parameters as potential prognostic biomarkers for differentiating SM from UM in a Ghanaian population. A descriptive cross-sectional study was conducted to sample 166 participants, comprising 42 healthy controls, 78 uncomplicated malaria cases, and 46 severe malaria cases. Blood samples were analysed for full blood count, liver function test, renal function test, and serum angiopoietins. Statistical analyses were carried out using GraphPad Prism 9 software. Median and interquartile ranges, Mann-Whitney U test, and Kruskal-Wallis analysis were done to compare groups. The haemoglobin and platelet counts of SM patients were significantly lower than those of the UM group (p < 0.05). However, the White Blood Cell (WBC) counts of severe malaria patients (7.4, IQR: 5.4 - 10.6) were significantly higher than the uncomplicated malaria population (5.7, IQR: 5.0 - 6.5) (p < 0.001). Serum levels of bilirubin (total and direct), alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), and total proteins in severe malaria were significantly higher than uncomplicated malaria group (p < 0.001). These findings indicate that haemoglobin, platelet, creatinine, urea, AST, ALT, GGT and bilirubin levels may serve as biomarkers for distinguishing severe from uncomplicated malaria.

Published in	American Journal of Laboratory Medicine (Volume 11, Issue 1)
DOI	10.11648/j.ajlm.20261101.11
Page(s)	1-8
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Malaria, Haematologic, Biochemical, Prognostic

References

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APA Style

Boadi, E., Annani-Akollor, M. E., Nkrumah, C., Paintsil, E. K., Eshun, A. E., et al. (2026). Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa. American Journal of Laboratory Medicine, 11(1), 1-8. https://doi.org/10.11648/j.ajlm.20261101.11

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ACS Style

Boadi, E.; Annani-Akollor, M. E.; Nkrumah, C.; Paintsil, E. K.; Eshun, A. E., et al. Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa. Am. J. Lab. Med. 2026, 11(1), 1-8. doi: 10.11648/j.ajlm.20261101.11

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AMA Style

Boadi E, Annani-Akollor ME, Nkrumah C, Paintsil EK, Eshun AE, et al. Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa. Am J Lab Med. 2026;11(1):1-8. doi: 10.11648/j.ajlm.20261101.11

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@article{10.11648/j.ajlm.20261101.11,
  author = {Enoch Boadi and Max Efui Annani-Akollor and Christopher Nkrumah and Ellis Kobina Paintsil and Anthony Eric Eshun and Lydia Omari and Yaw Frimpong and Egote Alexander Kofi},
  title = {Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa},
  journal = {American Journal of Laboratory Medicine},
  volume = {11},
  number = {1},
  pages = {1-8},
  doi = {10.11648/j.ajlm.20261101.11},
  url = {https://doi.org/10.11648/j.ajlm.20261101.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20261101.11},
  abstract = {Malaria is classified as either uncomplicated (UM) or severe (SM), but the mechanism underlying the progression from uncomplicated to severe is still unclear. This study aimed to assess haematologic and biochemical parameters as potential prognostic biomarkers for differentiating SM from UM in a Ghanaian population. A descriptive cross-sectional study was conducted to sample 166 participants, comprising 42 healthy controls, 78 uncomplicated malaria cases, and 46 severe malaria cases. Blood samples were analysed for full blood count, liver function test, renal function test, and serum angiopoietins. Statistical analyses were carried out using GraphPad Prism 9 software. Median and interquartile ranges, Mann-Whitney U test, and Kruskal-Wallis analysis were done to compare groups. The haemoglobin and platelet counts of SM patients were significantly lower than those of the UM group (p < 0.05). However, the White Blood Cell (WBC) counts of severe malaria patients (7.4, IQR: 5.4 - 10.6) were significantly higher than the uncomplicated malaria population (5.7, IQR: 5.0 - 6.5) (p < 0.001). Serum levels of bilirubin (total and direct), alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), and total proteins in severe malaria were significantly higher than uncomplicated malaria group (p < 0.001). These findings indicate that haemoglobin, platelet, creatinine, urea, AST, ALT, GGT and bilirubin levels may serve as biomarkers for distinguishing severe from uncomplicated malaria.},
 year = {2026}
}

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TY  - JOUR
T1  - Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa
AU  - Enoch Boadi
AU  - Max Efui Annani-Akollor
AU  - Christopher Nkrumah
AU  - Ellis Kobina Paintsil
AU  - Anthony Eric Eshun
AU  - Lydia Omari
AU  - Yaw Frimpong
AU  - Egote Alexander Kofi
Y1  - 2026/01/16
PY  - 2026
N1  - https://doi.org/10.11648/j.ajlm.20261101.11
DO  - 10.11648/j.ajlm.20261101.11
T2  - American Journal of Laboratory Medicine
JF  - American Journal of Laboratory Medicine
JO  - American Journal of Laboratory Medicine
SP  - 1
EP  - 8
PB  - Science Publishing Group
SN  - 2575-386X
UR  - https://doi.org/10.11648/j.ajlm.20261101.11
AB  - Malaria is classified as either uncomplicated (UM) or severe (SM), but the mechanism underlying the progression from uncomplicated to severe is still unclear. This study aimed to assess haematologic and biochemical parameters as potential prognostic biomarkers for differentiating SM from UM in a Ghanaian population. A descriptive cross-sectional study was conducted to sample 166 participants, comprising 42 healthy controls, 78 uncomplicated malaria cases, and 46 severe malaria cases. Blood samples were analysed for full blood count, liver function test, renal function test, and serum angiopoietins. Statistical analyses were carried out using GraphPad Prism 9 software. Median and interquartile ranges, Mann-Whitney U test, and Kruskal-Wallis analysis were done to compare groups. The haemoglobin and platelet counts of SM patients were significantly lower than those of the UM group (p < 0.05). However, the White Blood Cell (WBC) counts of severe malaria patients (7.4, IQR: 5.4 - 10.6) were significantly higher than the uncomplicated malaria population (5.7, IQR: 5.0 - 6.5) (p < 0.001). Serum levels of bilirubin (total and direct), alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), and total proteins in severe malaria were significantly higher than uncomplicated malaria group (p < 0.001). These findings indicate that haemoglobin, platelet, creatinine, urea, AST, ALT, GGT and bilirubin levels may serve as biomarkers for distinguishing severe from uncomplicated malaria.
VL  - 11
IS  - 1
ER  -

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Author Information

Enoch Boadi

Laboratory Department, Bremang Seventh-Day Adventist Hospital, Kumasi, Ghana;Department of Medical Laboratory Science, Miezah University College, Kumasi, Ghana

Contact Email

http://orcid.org/0009-0006-8857-6611
Max Efui Annani-Akollor

Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

Contact Email
Christopher Nkrumah

Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Laboratory Department, Wenchi Methodist Hospital, Wenchi, Ghana

Contact Email

http://orcid.org/0000-0001-7847-8061
Ellis Kobina Paintsil

Laboratory Department, Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana;Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

Contact Email

http://orcid.org/0000-0001-8385-1326
Anthony Eric Eshun

Laboratory Department, Bremang Seventh-Day Adventist Hospital, Kumasi, Ghana

Contact Email
Lydia Omari

Department of Midwifery, Nursing and Midwifery Training School, Fomena, Ghana

Contact Email
Yaw Frimpong

Department of Medical Laboratory, Unilab Diagnostics Limited, Kumasi, Ghana

Contact Email
Egote Alexander Kofi

Department of Nursing, Miezah College of Health, Kumasi, Ghana

Contact Email

http://orcid.org/0000-0002-8697-7837

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APA Style

Boadi, E., Annani-Akollor, M. E., Nkrumah, C., Paintsil, E. K., Eshun, A. E., et al. (2026). Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa. American Journal of Laboratory Medicine, 11(1), 1-8. https://doi.org/10.11648/j.ajlm.20261101.11

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ACS Style

Boadi, E.; Annani-Akollor, M. E.; Nkrumah, C.; Paintsil, E. K.; Eshun, A. E., et al. Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa. Am. J. Lab. Med. 2026, 11(1), 1-8. doi: 10.11648/j.ajlm.20261101.11

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AMA Style

Boadi E, Annani-Akollor ME, Nkrumah C, Paintsil EK, Eshun AE, et al. Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa. Am J Lab Med. 2026;11(1):1-8. doi: 10.11648/j.ajlm.20261101.11

Copy | Download

@article{10.11648/j.ajlm.20261101.11,
  author = {Enoch Boadi and Max Efui Annani-Akollor and Christopher Nkrumah and Ellis Kobina Paintsil and Anthony Eric Eshun and Lydia Omari and Yaw Frimpong and Egote Alexander Kofi},
  title = {Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa},
  journal = {American Journal of Laboratory Medicine},
  volume = {11},
  number = {1},
  pages = {1-8},
  doi = {10.11648/j.ajlm.20261101.11},
  url = {https://doi.org/10.11648/j.ajlm.20261101.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20261101.11},
  abstract = {Malaria is classified as either uncomplicated (UM) or severe (SM), but the mechanism underlying the progression from uncomplicated to severe is still unclear. This study aimed to assess haematologic and biochemical parameters as potential prognostic biomarkers for differentiating SM from UM in a Ghanaian population. A descriptive cross-sectional study was conducted to sample 166 participants, comprising 42 healthy controls, 78 uncomplicated malaria cases, and 46 severe malaria cases. Blood samples were analysed for full blood count, liver function test, renal function test, and serum angiopoietins. Statistical analyses were carried out using GraphPad Prism 9 software. Median and interquartile ranges, Mann-Whitney U test, and Kruskal-Wallis analysis were done to compare groups. The haemoglobin and platelet counts of SM patients were significantly lower than those of the UM group (p < 0.05). However, the White Blood Cell (WBC) counts of severe malaria patients (7.4, IQR: 5.4 - 10.6) were significantly higher than the uncomplicated malaria population (5.7, IQR: 5.0 - 6.5) (p < 0.001). Serum levels of bilirubin (total and direct), alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), and total proteins in severe malaria were significantly higher than uncomplicated malaria group (p < 0.001). These findings indicate that haemoglobin, platelet, creatinine, urea, AST, ALT, GGT and bilirubin levels may serve as biomarkers for distinguishing severe from uncomplicated malaria.},
 year = {2026}
}

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TY  - JOUR
T1  - Haematologic and Biochemical Parameters to Differentiate Severe Malaria from Uncomplicated Malaria in a Ghanaian Population in Sub-Saharan Africa
AU  - Enoch Boadi
AU  - Max Efui Annani-Akollor
AU  - Christopher Nkrumah
AU  - Ellis Kobina Paintsil
AU  - Anthony Eric Eshun
AU  - Lydia Omari
AU  - Yaw Frimpong
AU  - Egote Alexander Kofi
Y1  - 2026/01/16
PY  - 2026
N1  - https://doi.org/10.11648/j.ajlm.20261101.11
DO  - 10.11648/j.ajlm.20261101.11
T2  - American Journal of Laboratory Medicine
JF  - American Journal of Laboratory Medicine
JO  - American Journal of Laboratory Medicine
SP  - 1
EP  - 8
PB  - Science Publishing Group
SN  - 2575-386X
UR  - https://doi.org/10.11648/j.ajlm.20261101.11
AB  - Malaria is classified as either uncomplicated (UM) or severe (SM), but the mechanism underlying the progression from uncomplicated to severe is still unclear. This study aimed to assess haematologic and biochemical parameters as potential prognostic biomarkers for differentiating SM from UM in a Ghanaian population. A descriptive cross-sectional study was conducted to sample 166 participants, comprising 42 healthy controls, 78 uncomplicated malaria cases, and 46 severe malaria cases. Blood samples were analysed for full blood count, liver function test, renal function test, and serum angiopoietins. Statistical analyses were carried out using GraphPad Prism 9 software. Median and interquartile ranges, Mann-Whitney U test, and Kruskal-Wallis analysis were done to compare groups. The haemoglobin and platelet counts of SM patients were significantly lower than those of the UM group (p < 0.05). However, the White Blood Cell (WBC) counts of severe malaria patients (7.4, IQR: 5.4 - 10.6) were significantly higher than the uncomplicated malaria population (5.7, IQR: 5.0 - 6.5) (p < 0.001). Serum levels of bilirubin (total and direct), alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), and total proteins in severe malaria were significantly higher than uncomplicated malaria group (p < 0.001). These findings indicate that haemoglobin, platelet, creatinine, urea, AST, ALT, GGT and bilirubin levels may serve as biomarkers for distinguishing severe from uncomplicated malaria.
VL  - 11
IS  - 1
ER  -

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