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| Evaluation of Neutrophil Lymphocyte Ratio (NLR) in Sudanese Children with Falciparum Malaria |
Khalid Abdelsamea Mohamedahmed, Reem Ez eldeen Mustafa, Adam Dawoud Abakar, Bakri Yousif Mohammed Nour
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Abstract:
Severe falciparum malaria is one of the most world-wide infection among children leading to high mortality and morbidity especially in tropical regions. Neutrophil lymphocyte ratio (NLR) is prognostic and predictor factors indicative for inflammatory diseases, cancers, cardiovascular events, and in several types of infectious diseases such as falciparum malaria. The purpose of this study was to evaluate the neutrophil lymphocyte ratio (NLR) in Sudanese children with falciparum malaria. In addition to study association between NLR and malaria parasitemia and parasite count. A case control study was included 300 Sudanese children (100 severe falciparum malaria [with mean age 8.63 ± 3.40 years; 39% female], 100 uncomplicated falciparum malaria [with mean age 8.83 ± 4.20 years; 55% female] and 100 normal healthy children controls [with mean age 10.08 ± 3.58 years; 50% female]). The WBCs parameters measured using by Sysmex XP 300 N automated analyzer, and NLR counted by dividing absolute neutrophil count by the absolute lymphocytes count. The data were analyzed using SPSS software (V 20.0) and Stat disk software (V 13.0). Leukocytosis (34%) and increased NLR (30%) were observed in falciparum malaria cases. The mean of NLR in the falciparum malaria patients and control were (3.47 ± 3.51 and 2.87 ± 3.01 respectively) giving statistically significant difference in NLR between malaria cases and control (P value 0.000), while statistically insignificant differences in NLR between severe and mild malaria (P value 0.735). The study concluded that leukocytosis, increased NLR, absolute neutrophilia and absolute lymphocytopenia were observed as WBCs changes in falciparum malaria. Significant association was observed between development of severe falciparum malaria and absolute neutropenia. To improve management of severe malaria NLR may be recommended, along with others parameters, as predictive indicator for the disease severity among high risk groups.
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