Complete Blood Count Profile and Derived Inflammatory Markers in Children with Severe Acute Malnutrition Seen in Sokoto, North-Western Nigeria

K O Isezuo,A Adamu,T Yusuf,U.M Waziri,F B Jiya,M Amodu-Sanni,U M Sani,B I Garba

doi:10.24018/ejmed.2021.3.1.662

Abstract

Severe acute malnutrition (SAM) is a major cause of mortality among children in Nigeria. Majority of affected children die from sepsis related complications. The complete blood count includes inflammatory markers which have been found to be useful in predicting sepsis and mortality in children, but these findings have not been corroborated in our population. The aim of this study was to compare the haematological profile and inflammatory markers of severely malnourished children to age matched controls admitted for febrile illnesses. It was a cross sectional study carried out in the emergency paediatric unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto. Severely malnourished children aged 6 months to 5 years and a comparative cohort who were not severely malnourished were consecutively recruited as they presented for admission. Relevant data were entered into a proforma and blood samples taken for complete blood count amongst others. Total and differential white cell counts, lymphocyte-neutrophil ratio and platelet indices were compared. There were 64 children comprising 32 severely malnourished and 32 well-nourished children. Mean white cell count, absolute lymphocyte and monocytes were significantly higher among the malnourished while mean platelet volume (MPV) and platelet distribution width (PDW) were significantly lower for the malnourished subjects. There were eight mortalities all among the malnourished children and mean neutrophil count was significantly higher among the mortalities. In conclusion, severely malnourished children had more lymphocytosis, however, mortality was associated with neutrophilia. Platelet indices of inflammation were lower in malnourished than non-malnourished subjects.

Highlights

Severe acute malnutrition (SAM) is a major cause of mortality among children aged under five years in Nigeria
All (100%) of the SAM patients were of low socioeconomic status whereas 19 (59.4%) of the non-SAM group were of low social status. (Table I)
The differential counts were more of lymphocytes and other white cells while the neutrophils percentage was lower in the malnourished group

Summary

Introduction

Severe acute malnutrition (SAM) is a major cause of mortality among children aged under five years in Nigeria. It contributes to about 50% of under-five mortality with a mortality rate ranging from 10% to 40% in hospitalized cases [1]. Overwhelming infection to which they lack ability to mount adequate immune response is a major cause of mortality in them [2]. The complete blood count is a relatively available and affordable test which is routine and practical. It provides information about a patients’ blood components [3]

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Conclusion