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Research Snapshot Theater: Sepsis, Pediatric III

Hematological Parameters as Prognostic Biomarkers for Sepsis and Malaria in Resource-Limited Setting

Monday, March 23, 2026
11:30 AM - 12:30 PM Central Time
Location: Connections Central - RST 14

  • Kwadwo Danso, MBChB (he/him/his)

    University of Illinois College of Medicine Peoria, Illinois

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • Sarah Mayer, MD (she/her/hers)

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • FO

    Fangqian Ouyang, MS

    Biostatistician II
    Department of Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health, Indiana University School of Medicine,

    Disclosure information not submitted.

  • SR

    Sawai Rathore, MD

    Internal Medicine Resident
    Ascension St. Vincent Hospital Indianapolis (Milwaukee) Program, Milwaukee, Wisconsin

    Disclosure information not submitted.

  • Kn

    Kate nielsen, MD, MPH

    Associate Professor, Pediatric Critical Care Medicine, Adjunct Associate Professor, Global Health
    University of Washington/Seattle Children’s Hospital

    Disclosure information not submitted.

  • Av

    Amelie von Saint Andre-von Arnim, MD

    Associate Professor, Department of Pediatrics, Division of Pediatric Critical Care
    University of Washington/Seattle Children's Hospital

    Disclosure information not submitted.

  • MK

    Maria-Charlyne Kilba, MBChB, MPhil, FGCPS

    Paediatric Intensivist
    Greater Accra Regional Hospital, Accra College of Medicine

    Disclosure information not submitted.

  • JJ

    Juan Jaramillo-Bustamante, MD

    Pediatric Intensivist
    Hospital General de Medellín. Hospital Pablo Tobón Uribe., Colombia

    Disclosure information not submitted.

  • AF

    Ana Fustiñana, n/a

    MD
    Garrahan Hospital: Buenos Aires, Buenos Aires, Argentina

    Disclosure information not submitted.

  • TB

    Tigist Bacha, MD, MPH

    Associate Professor of Pediatric Emergency and Critical Care
    St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

    Disclosure information not submitted.

  • Jhuma Sankar, MD

    All India Institute of Medical Scinces, Delhi, IND

    Disclosure information not submitted.

  • AH

    Adrian Holloway, MD

    Associate Professor
    University of Maryland Children's Hospital, Maryland

    Disclosure information not submitted.

  • MW

    Matthew Wiens, PharmD, PhD

    Assistant Professor
    Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia

    Disclosure information not submitted.

  • Niranjan Kissoon, MD, MBBS, FRCP(C)

    British Columbia's Children's Hosp., British Columbia, CAN

    Disclosure information not submitted.

  • Teresa B. Kortz, MD (she/her/hers)

    University of California San Francicso, California

    Disclosure information not submitted.

  • Kenneth Remy, MD, MSc, MSCI, FCCM

    Case Western Reserve University/University Hospitals Cleveland Medical Center, Ohio

    Disclosure(s): No relevant financial relationship(s) to disclose.

Introduction: In resource-constrained settings (RCS), advanced laboratory diagnostics during pediatric critical illness remain limited. Hematologic parameters like platelet/lymphocyte ratio (PLR) and white cell/platelet ratio (WPR) have shown correlation with disease severity in adults and neonates, and may be cost-effective prognostic tools. This secondary analysis of the Global PARITY point prevalence study evaluated the relationship between these two hematologic ratios and clinical outcomes among pediatric patients with sepsis and malaria in RCS.


Methods: We calculated PLR and WPR based on availability, from admission complete blood counts of patients with sepsis and malaria from Global PARITY’s 46 RCS sites in 19 countries. Sepsis was defined per clinician diagnosis. Clinical outcomes included mortality and organ dysfunction, using established severity scores (LODS, LqSOFA). Statistical analyses included Mann-Whitney U tests for continuous variables, chi-square for categorical comparisons across quartiles, and Spearman/Pearson correlation analyses with severity scores.


Results: In the sepsis cohort (n=660), among 295 patients with PLR data, non-survivors (n=9) had significantly higher PLR compared to survivors (n=286): 168.71 vs 91.94; P=0.02 and lower lymphocyte counts (2.29 vs 3.94; P=0.02). Mortality from sepsis increased from 0% in the lowest to a combined 77.7% in the higher PLR quartiles, while WPR did not correlate with mortality outcome in this group. PLR did not correlate with the severity scores in this group. In the malaria cohort (n=175), among 91 patients with WPR data, non-survivors (n=6) had significantly higher WPR compared to survivors (n=85): 0.15 vs 0.06; P=0.01 and lower platelet counts (52 vs 204; P< 0.01). All the malaria mortalities occurred in the higher WPR quartiles, with PLR not correlating to mortality outcomes in this group. WPR correlated with LODS (r=0.37, P< 0.01), and LqSOFA (r=0.35, P=0.05) severity scores.


Conclusions: PLR and WPR are promising, low-cost prognostic biomarkers in sepsis and malaria in RCS sites. PLR was associated with sepsis mortality, and WPR was associated with malaria mortality and organ dysfunction. These simple hematologic ratios may improve early risk stratification in RCS, and prospective studies are warranted to validate these biomarkers.