Influence of Malaria Parasitemia of Plasmodium Falciparum on the Prevalence and Severity of Premenstrual Syndrome

Abstract

Introduction: It remains unknown whether Malaria Parasitemia (MP) of Plasmodium falciparum might influence symptoms in Premenstrual Syndrome (PMS). Symptoms of PMS might be not only hormonal but also haematologically related. However, the link of Plasmodium falciparum infection and clinical manifestations of PMS has not been previously investigated. Aim: To determine the association of MP of Plasmodium falciparum and Packed Cell Volume parameters (PCV) with clinical characteristics of PMS. Materials and Methods: A cross-sectional study was carried out in 2014 among undergraduate students in the University. The study participants completed a two-part questionnaire assessing premenstrual dysphoric disorder and PMS symptoms using the Diagnostic and Statistical Manual of Mental DisorderIV (DSM-IV) based diagnostic criteria. Peripheral blood sample for MP and PCV estimation were also collected at enrollment. Statistical analysis was performed with SPSS version 20.0 (IBM, Armonk, NY, USA). Categorical variables were summarized by absolute frequencies, percentages, and chi-square tests and continuous variables by means and standard deviation. Values were deemed statistically significant at p<0.05. Results: A total of 150 randomly selected participants aged 16–30 years were enrolled. Of the 150 students, 105 (70.0%) regularly experienced symptoms suggestive of PMS. The commonest symptoms were lower abdominal pain (80.0%), joint and muscle pain (72.0%) and pimples/puffy face (65.3%) while the least frequent symptoms were cramps (33.3%) and vaginal discharge (30.0%). Thirty one (20.7%) out of 150 participants were positive for MP and 6 (4.0%) participants had low PCV (<0.33) and all of which tested positive to MP. Compared with PMS negative, the mean PCV in PMS positive participants was statistically lower (0.30±0.033 vs 0.36±0.038, p=0.007). Conclusion: This is the first study to reveal a potential association of MP and PCV with clinical manifestations of PMS. PMS is a prevalent, yet undertreated, disorder among the participants with malaria parasite infestation worsening the condition leading to low PCV values, which adversely affect their quality of life and academic performance of the participants. The findings warrant further research.

Keywords

• association
• diagnostic criteria
• haematological parameter
• symptoms