ArticleMalaria journal2013
Predictive value of lymphocytopenia and the neutrophil-lymphocyte count ratio for severe imported malaria.
Article in Malaria journal, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 4 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 4 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Neutrophil-to-lymphocyte ratio for the clinical management of dengue: a systematic review and meta-analysis.Frontiers in epidemiology · 2026Pooled it
- C-reactive protein as an early biomarker for malaria infection and monitoring of malaria severity: a meta-analysis.Scientific reports · 2021Pooled it
- Reduction in total leukocytes in malaria patients compared to febrile controls: A systematic review and meta-analysis.PloS one · 2020Pooled it
- The utility of peripheral blood leucocyte ratios as biomarkers in infectious diseases: A systematic review and meta-analysis.The Journal of infection · 2019Pooled it
- Circulating immunoglobulins and transient lymphocytopenia in a sub-study of CAPRISA 012B, testing HIV monoclonal antibodies in a phase 1 trial.Scientific reports · 2024Trial
- Changes in total and differential leukocyte counts during the clinically silent liver phase in a controlled human malaria infection in malaria-naïve Dutch volunteers.Malaria journal · 2017Trial
- Decoding Leukocyte Dynamics: Functional Biomarkers and Precision Diagnostics in Parasitic Infections.Acta parasitologica · 2026Review
- Decoding Leukocyte Dynamics: Functional Biomarkers and Precision Diagnostics in Parasitic Infections.Acta parasitologica · 2026Review
- Naturally acquired antibodies toFrontiers in immunology · 2026Article
- Overview of the host immune response toJournal of parasitic diseases : official organ of the Indian Society for Parasitology · 2025Review
- Comparative Analysis of Initial Full Blood Count Parameters in Adults Infected WithOpen forum infectious diseases · 2025Article
- Multi-system dysregulation in placental malaria contributes to adverse perinatal outcomes in mice.Infection and immunity · 2025Article
- Association Between Plasmodium Infection and Blood Count Values: Implications for Malaria Diagnosis in Resource-Limited Settings.Acta parasitologica · 2025Article
- Haematological abnormalities as diagnostic indicators of malaria in returning travellers: a retrospective study at Mohamed V Military Instruction Hospital.Access microbiology · 2025Article
- Depolarization diagrams for circularly polarized light scattering for biological particle monitoring.Journal of biomedical optics · 2024Article
- Article
- Estimation of parasitaemia in imported falciparum malaria using the results of a combined rapid diagnostic test. No big help from haematological parameters.Malaria journal · 2023Observational
- Haematological parameters and their correlation with the degree of malaria parasitaemia among outpatients attending a polyclinic.Malaria journal · 2023Article
- Increased Neutrophil Percentage and Neutrophil-T Cell Ratio Precedes Clinical Onset of Experimental Cerebral Malaria.International journal of molecular sciences · 2023Article
- Article
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8 authors at 4 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundLymphocytopenia has frequently been described in patients with malaria, but studies on its association with disease severity have yielded conflicting results. The neutrophil/lymphocyte count ratio (NLCR) has been introduced as a parameter for systemic inflammation in critically ill patients and was found, together with lymphocytopenia, to be a better predictor of bacteraemia than routine parameters like C-reactive protein and total leukocyte count. In the present study, the predictive value of the NLCR and lymphocytopenia for severe disease was evaluated in patients with imported malaria.
methodsAll patients diagnosed with malaria at the Harbour Hospital between January 1st 1999 and January 1st 2012 with differential white cell counts determined within the first 24 hours after admission were included in this retrospective study. Severe malaria was defined according to the WHO criteria. The performance of the NLCR and lymphocytopenia as a marker of severe malarial disease was compared back-to-back with that of C-reactive protein as a reference biomarker.
resultsA total of 440 patients (severe falciparum malaria n = 61, non-severe falciparum malaria n = 259, non-falciparum malaria n=120) were included in the study. Lymphocytopenia was present in 52% of all patients and the median NLCR of all patients was 3.2. Total lymphocyte counts and NLCR did not differ significantly between groups. A significant correlation of total leukocyte count and NLCR, but not lymphocyte count, with parasitaemia was found. ROC analysis revealed a good negative predictive value but a poor positive predictive value of both lymphocytopenia and NLCR and performance was inferior to that of C-reactive protein. After complete parasite clearance a significant rise in total leukocyte count and lymphocyte count and a significant decrease in NLCR was observed.
conclusionThe NLCR was found to correlate with parasitaemia, but both lymphocytopenia and the NLCR were inferior to C-reactive protein as markers for severe disease in patients with imported malaria. The NLCR and lymphocytopenia are not useful as predictive markers for severe disease in imported malaria in the acute care setting.
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