Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Jun 9, 2024; 13(2): 92392
Published online Jun 9, 2024. doi: 10.5409/wjcp.v13.i2.92392
Diagnostic significance of complete blood cell count and hemogram-derived markers for neonatal sepsis at Southwest Public Hospitals, Ethiopia
Dereje Abebe Regassa, Rahel Shumi Nagaash, Bisirat Fikadu Habtu, Woyesa Beyene Haile
Dereje Abebe Regassa, Rahel Shumi Nagaash, Bisirat Fikadu Habtu, Department of Medical Laboratory Sciences, Wolkite University, Wolkite 11330, Ethiopia
Woyesa Beyene Haile, Department of Medical Laboratory Sciences, Dire Dawa University, Dire Dawa 3000, Ethiopia
Author contributions: Regassa DA contributed to the conceptualization and design of the study; Regassa DA, Nagaash RS, Habtu BF, and Haile WB have participated in data acquisition, analysis, interpretation, and drafted the manuscript; all authors have read and approved the final version of manuscript for submission.
Institutional review board statement: Before the study began, our study obtained the approved ethical clearance from the local Institutional Review Board of Research (Ref. No BEFO176981/2023, Oromia Health Bureau, Ethiopia).
Informed consent statement: Before the study began, we obtained consent from the local Institutional Review Board of Research (Ref. No BEFO176981/2023, Oromia Health Bureau, Ethiopia) and received ethical clearance from Tulu Bolo General Hospital and Waliso General Hospital administration offices, as well as the Pediatric Intensive Care Unit head offices. Once we obtained permission from the hospital administrator and the head of the pediatrician clinic care unit, we collected the data from record data. We ensured the confidentiality and privacy of the obtained information. Our study adhered to the principle of the Helsinki Declaration (64th WMA General Assembly). Individual patient consent was not required as all data used in this study was acquired retrospectively from the laboratory information system and medical records without any additional blood sampling.
Conflict-of-interest statement: This research did not receive any specific grant from any funding agencies and the authors declare no conflicts of interest for this study.
Data sharing statement: The datasets analyzed during the current study are available from the corresponding author upon reasonable request via address sifaanabebe@gmail.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dereje Abebe Regassa, MSc, Lecturer, Department of Medical Laboratory Sciences, Wolkite University, Gubre, Wolkite 11330, Ethiopia. sifaanabebe@gmail.com
Received: January 24, 2024
Revised: February 11, 2024
Accepted: April 12, 2024
Published online: June 9, 2024
Processing time: 135 Days and 4.1 Hours
Abstract
BACKGROUND

Neonatal sepsis is defined as an infection-related condition characterized by signs and symptoms of bacteremia within the first month of life. It is the leading cause of mortality and morbidity among newborns. While several studies have been conducted in other parts of world to assess the usefulness of complete blood count parameters and hemogram-derived markers as early screening tools for neonatal sepsis, the associations between sepsis and its complications with these blood parameters are still being investigated in our setting and are not yet part of routine practice.

AIM

To evaluate the diagnostic significance of complete blood cell count hemogram-derived novel markers for neonatal sepsis among neonates attending public hospitals in the southwest region of Oromia, Ethiopia, through a case control study.

METHODS

A case control study was conducted from October 2021 to October 2023 Sociodemographic, clinical history, and laboratory test results data were collected using structured questionnaires. The collected data were entered into Epi-data 3.1 version and exported to SPSS-25 for analysis. Chi-square, independent sample t-test, and receiver operator characteristics curve of curve were used for analysis. A P-value of less than 0.05 was considered statistically significant.

RESULTS

In this study, significant increases were observed in the following values in the case group compared to the control group: In white blood cell (WBC) count, neutrophils, monocyte, mean platelet volume (MPV), neutrophils to lymphocyte ratio, monocyte to lymphocyte ratio (MLR), red blood cell width to platelet count ratio (RPR), red blood width coefficient variation, MPV to RPR, and platelet to lymphocyte ratio. Regarding MLR, a cut-off value of ≥ 0.26 was found, with a sensitivity of 68%, a specificity of 95%, a positive predictive value (PPV) of 93.2%, and a negative predictive value (NPV) of 74.8%. The area under the curve (AUC) was 0.828 (P < 0.001). For WBC, a cut-off value of ≥ 11.42 was identified, with a sensitivity of 55%, a specificity of 89%, a PPV of 83.3%, and a NPV of 66.4%. The AUC was 0.81 (P < 0.001). Neutrophils had a sensitivity of 67%, a specificity of 81%, a PPV of 77.9%, and a NPV of 71.1%. The AUC was 0.801, with a cut-off value of ≥ 6.76 (P = 0.001). These results indicate that they were excellent predictors of neonatal sepsis diagnosis.

CONCLUSION

The findings of our study suggest that certain hematological parameters and hemogram-derived markers may have a potential role in the diagnosis of neonatal sepsis.

Keywords: Complete blood count; Hemogram-derived marker; Neonate; Sepsis; Ethiopia

Core Tip: It is try to show the importance of complete blood cell count and hemogram-derived markers for the neonatal sepsis, which are simple and accessible relative culture especially in developing countries like Ethiopia.