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


  •   K. O. Isezuo

  •   U. M. Sani

  •   U.M Waziri

  •   B. I. Garba

  •   M. Amodu-Sanni

  •   A. Adamu

  •   F. B. Jiya

  •   T. Yusuf


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.

Keywords: SAM, FBC, MPV, NLR, PDW, sepsis, mortality


Gachau S, Irimu G, Ayieko P, Akech S, Agweyu A, et al. Prevalence, outcome and quality of care among children hospitalized with severe acute malnutrition in Kenyan hospitals: A multi-site observational study. PLOS ONE 2018; 13: e0197607.

Rytter MJH, Kolte L, Briend A, Friis H, Christensen VB. The Immune System in Children with Malnutrition. A Systematic Review. PLOS ONE 2014; 9 (8): e105017.

Ted Gordon-Smith,Structure and function of red and white blood cells, Medicine,Volume 41, Issue 4,2013,Pages193-199,ISSN 1357-3039,

Tamelytė E, Vaičekauskienė G, Dagys A, Lapinskas T, Jankauskaitė L. Early Blood Biomarkers to Improve Sepsis/Bacteremia Diagnostics in Pediatric Emergency Settings. Medicinia (Kaunas) 2019; 55 (4): 99.

Karadag-Oncel E, Ozsurekci Y, Kara A, Karahan S, Cengiz AB, Ceyhan M. The value of mean platelet volume in the determination of community acquired pneumonia in children. Italian Journal of Pediatrics 2013; 39:16.

Orak M, Karakoç Y, Ustundag M, Yildirim Y, Celen MK, Güloglu C. An investigation of the effects of the mean platelet volume, platelet distribution width, platelet/lymphocyte ratio, and platelet counts on mortality in patents with sepsis who applied to the emergency department. Niger J Clin Pract. 2018;21(5):667-671. doi: 10.4103/njcp.njcp_44_17. PMID: 29735870.

Araújo FDDR, Silva RMFDL, Oliveira CAL, Meira ZMA. Neutrophil-to-lymphocyte ratio used as prognostic factor marker for dilated cardiomyopathy in childhood and adolescence. Ann Pediatr Cardiol. 2019;12(1):18-24. doi: 10.4103/apc.APC_47_18. PMID: 30745765; PMCID: PMC6343383.

Golwala ZM, Shah H, Gupta N, Sreenivas V, Puliyel JM. Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Count and Plateletcrit (PCT) as predictors of in-hospital paediatric mortality: a case-control Study. Afr Health Sci. 2016;16(2):356-62. doi: 10.4314/ahs.v16i2.3. PMID: 27605950; PMCID: PMC4994558.

Severe Acute Malnutrition Management in Nigeria. (2019) Challenges, Lessons and the road ahead. Executive Summary March 2015. ACF International.

National Population Commission. 2006 National Census: Federal Republic of Nigeria Official Gazette, 2007; 94(24):196. W.-K. Chen, Linear Networks and Systems, Belmont, CA: Wadsworth, 1993, pp. 123-135.

Udo R, Mamman A. Nigeria: Giant in the tropics. State surveys, 1993:435-446.

Spring. 2018. Assessing Drivers of Malnutrition in Nigeria: A Report on Findings from Kebbi, Niger, Benue, and Cross River to Inform Food Security Investments. Arlington, VA: Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project. (accessed 3/1/2021).

Araoye MO. Sample size calculation in: MO Araoye. Research Methodology with Statistics for Health and Social Sciences. Nathdex (Publ) Ilorin 2004;115-121.

Basheir, Haider & Hamza, Khalda. Hematological Parameters of Malnourished Sudanese Children Under 5 Years – Khartoum State – 2011. Journal of Clinical Medicine 2015; 1(4):152-156.

Aliyu I, Ibrahim HU, Idris U, Michael GC, Ibrahim UA, Mohammed A, Ahmad I, Habib JM. The clinical profile and outcome of children with acute malnutrition in a tertiary health center in North-West Nigeria: A 1-year retrospective review. J Clin Sci 2020;17:120-6.

Adegoke, Olufemi & Arif, Muhammad & Bahwere, Paluku & Harb, Jana & Hug, Julia & Jasper, Paul & Mudzongo, Paul & Nanama, Simeon & Olisenekwu, Gloria & Visram, Aly. Incidence of severe acute malnutrition after treatment: A prospective matched cohort study in Sokoto, Nigeria. Maternal & Child Nutrition 2000;17. 10.1111/mcn.13070.

Rytter MJ, Kolte L, Briend A, Friis H, Christensen VB. The immune system in children with malnutrition--a systematic review. PLoS One. 2014;9(8):e105017. doi: 10.1371/journal.pone.0105017. PMID: 25153531; PMCID: PMC4143239.Giv.

WHO 2013. Guideline: Updates on the Management of Severe Acute Malnutrition in Infants and Children. Geneva: WHO.

Ernest N, Akpan P and Emmanuel UKO. Reduced Levels of Some Iron Parameters of PEM Malnourished Children. Journal of Biology, Agriculture and Health Care 2013; 3 (13): 114-120.

Holub, Michal & Beran, Ondřej & Kaspříková, Nikola & Chalupa, Pavel. Neutrophil to lymphocyte count ratio as a biomarker of bacterial infections. Central European Journal of Medicine 2012; 7. 10.2478/s11536-012-0002-3.

Dursun A, Ozsoylu S, Akyildiz BN. Neutrophil-to-lymphocyte ratio and mean platelet volume can be useful markers to predict sepsis in children. Pak J Med Sci 2018;34(4):918-922. doi: 10.12669/pjms.344.14547. PMID: 30190753; PMCID: PMC6115542.

Bekdas M, Goksugur SB, Sarac EG, Erkocoglu M, Demircioglu F. Neutrophil/lymphocyte and C-reactive protein/mean platelet volume ratios in differentiating between viral and bacterial pneumonias and diagnosing early complications in children. Saudi Med J. 2014;35(5):442–447.

Tekin M, Konca C, Gulyuz A, Uckardes F, Turgut M. Is the mean platelet volume a predictive marker for the diagnosis of acute pyelonephritis in children? Clin Exp Nephrol. 2015;19(4):688–693. doi:10.1007/s10157-014-1049-z.

Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010;14:28–32.

Sayed, Samira & Mahmoud, Mohamed & Moness, Hend & Mousa, Suzan. Admission platelet count and indices as predictors of outcome in children with severe Sepsis: a prospective hospital-based study. BMC Pediatrics 2020; 20. 10.1186/s12887-020-02278-4.

Golwala ZM, Shah H, Gupta N, Sreenivas V, Puliyel JM. Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Count and Plateletcrit (PCT) as predictors of in-hospital paediatric mortality: a case-control Study. Afr Health Sci 2016;16(2):356-62. doi: 10.4314/ahs.v16i2.3. PMID: 27605950; PMCID: PMC4994558.


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How to Cite
Isezuo, K. O., Sani, U. M., Waziri, U., Garba, B. I., Amodu-Sanni, M., Adamu, A., Jiya, F. B., & Yusuf, T. (2021). Complete Blood Count Profile and Derived Inflammatory Markers in Children with Severe Acute Malnutrition Seen in Sokoto, North-Western Nigeria. European Journal of Medical and Health Sciences, 3(1), 138-142.