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

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.