Academic Journal
Feasibility of manual white blood cell counts as a predictor of neonatal sepsis in a low-resource setting
| العنوان: | Feasibility of manual white blood cell counts as a predictor of neonatal sepsis in a low-resource setting |
|---|---|
| المؤلفون: | Golding, Christian N., Schaltz-Buchholzer, Frederik, Sanca, Lilica, Clipet-Jensen, Clara, Benn, Christine Stabell, Au, Nicholas, Chipperfield, Kate, Kollmann, Tobias R, Amenyogbe, Nelly |
| المصدر: | Golding , C N , Schaltz-Buchholzer , F , Sanca , L , Clipet-Jensen , C , Benn , C S , Au , N , Chipperfield , K , Kollmann , T R & Amenyogbe , N 2020 , ' Feasibility of manual white blood cell counts as a predictor of neonatal sepsis in a low-resource setting ' , Transactions of the Royal Society of Tropical Medicine & Hygiene , vol. 114 , no. 8 , pp. 566-574 . https://doi.org/10.1093/trstmh/traa023 |
| سنة النشر: | 2020 |
| المجموعة: | University of Southern Denmark: Research Output / Syddansk Universitet |
| مصطلحات موضوعية: | BCG Vaccine, leukocyte count, neonatal sepsis, newborn infant, oral poliovirus vaccine, western africa |
| الوصف: | Background Manual white blood cell (WBC) differential counts as a predictor for neonatal sepsis development in a low-resource setting have not been thoroughly evaluated. We hypothesized that manual differentiation (specifically immature:total [I:T] neutrophil ratios) would be feasible and useful as an adjunct to predict early-onset neonatal sepsis (EONS). Secondarily, we hypothesized that vaccination with bacillus Calmette-Guérin (BCG) and oral polio vaccine (OPV) could alter WBC differential counts and thus might reduce its predictive performance. Methods We performed a prospective cohort study within a randomized trial, randomizing healthy, high-risk newborns admitted to the nursery at the national hospital in Guinea-Bissau 1:1 to BCG+OPV at admission or at discharge (usual practice). Thin capillary blood films were prepared at 2 d of age in a subset of 268 neonates. WBC counts were assessed by microscopy and neonates were followed up for sepsis development within 2 weeks. Results Ninety-eight percent (264/268) of smears provided interpretable reads. Of the 264 children, 136 had been randomized to receive BCG+OPV prior to sampling; the remaining 128 were vaccinated at discharge. The I:T ratio (average 0.017) was lower among children who did not develop clinical sepsis but did not predict sepsis (p=0.70). Only three children had an I:T ratio >0.2 (associated with a higher probability of clinical sepsis in previous studies) but did not develop sepsis. Immunization did not alter WBC composition. Conclusions Manual WBC differentials are feasible in low-resource settings. WBC differentials are not affected by standard newborn immunization. However, the I:T ratio had no value in predicting subsequent development of sepsis. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | https://portal.findresearcher.sdu.dk/da/publications/a53a49f1-026f-4e51-aff4-dcc86ce0046e |
| DOI: | 10.1093/trstmh/traa023 |
| الاتاحة: | https://portal.findresearcher.sdu.dk/da/publications/a53a49f1-026f-4e51-aff4-dcc86ce0046e https://doi.org/10.1093/trstmh/traa023 |
| Rights: | info:eu-repo/semantics/closedAccess |
| رقم الانضمام: | edsbas.F25BD846 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/trstmh/traa023 |
|---|