THE PREDICTIVE VALUE OF TOTAL WHITE CELL COUNT AND ABSOLUTE NEUTROPHIL COUNT AS MARKERS OF EARLY NEONATAL SEPSIS IN A TERTIARY NEONATAL UNIT IN SUDAN
ABDELMONEIM E. M. KHEIR *
Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum / Soba University Hospital, Sudan.
OSAMA H. ELSHAZALI
Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum / Soba University Hospital, Sudan.
ISRA M. ABDULLAH
Department of Neonatology, Soba University Hospital, Sudan.
*Author to whom correspondence should be addressed.
Abstract
Background and Objectives: Neonatal sepsis remains an important cause of neonatal mortality in developing countries. The main objectives of this study were to evaluate the role of total white blood cell count and absolute neutrophil count in the diagnosis of neonatal sepsis.
Methods: This was a prospective, hospital-based study conducted in the neonatal intensive care unit at Soba University Hospital in Khartoum, Sudan, from January to
June 2018. 90 babies were included in the study. Data was collected using a specifically designed questionnaire including maternal and neonatal data. .Chi square test was used to study the correlation between risk factors for sepsis and absolute neutrophil count. P value was set at 0.05 level of significance.
Results: The main results showed that 14 babies (15.6%) had TWBCS less than 5000/ mm3, 69 babies (76.6%) had TWBCS between 5000-20000 /mm3 and 7 babies (7.8%) had TWBCS more than 20000 /mm3. 81(90%) had ANC more than 1800 mm3, 6 (6.7%) had ANC between 500-1000 /mm3, 3(3.3%) had ANC between less than 500 /mm3.The study showed that 71 babies (78.9%) had positive CRP. All babies included in the study had positive blood culture. Correlation between ANC and risk factors for sepsis showed that there was significant correlation between ANC and gestational age, mode of delivery, low Apgar score and UTI in the third trimester (P values = 0.020, 0.030, 0.036 and 0.020 respectively). The study showed that there was significant correlation between ANC and blood culture (p value = 0.00).
Conclusion: Total white cell count and absolute neutrphil count, being easily measurable and more affordable, can be conveniently used as good markers for the diagnosis of early neonatal sepsis especially in low resource setting.
Keywords: Neonatal sepsis, absolute neutrophil count, C-reactive protein, blood culture