{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:55:14Z","timestamp":1790610914950,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Sepsis remains a leading cause of morbidity and mortality worldwide, particularly in low\u2010 and middle\u2010income countries where diagnostic delays are common. The complete blood count (CBC) is widely used as an initial sepsis screening tool due to its availability and affordability. However, reliance on population\u2010based reference ranges, particularly white blood cell (WBC) counts, often leads to missed or delayed diagnosis, especially in early disease or among immunosuppressed patients. This article examines the diagnostic limitations of conventional CBC interpretation in suspected infection, and propose a personalized, baseline\u2010informed approach integrating C\u2010reactive protein (CRP) as an adjunct biomarker for early detection and monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach<\/jats:title>\n                    <jats:p>This perspective is based on a narrative synthesis of published literature on sepsis diagnostics, CBC parameters, and inflammatory biomarkers, combined with pathophysiological principles and clinical reasoning relevant to resource\u2010constrained settings. Evidence from diagnostic studies, systematic reviews, and guideline recommendations was conceptually analyzed to identify limitations of static laboratory thresholds and opportunities for personalized interpretation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Population\u2010based CBC reference ranges are limited in early sepsis detection due to inter\u2010individual variation. Personalized interpretation, considering baseline values and serial trends, improves sensitivity in identifying infection. CRP rises earlier and more consistently than WBC, particularly when hematologic responses are blunted. Integrating serial CRP measurements with baseline\u2010informed CBC trends enhances diagnostic utility, supports timely recognition, and improves monitoring of clinically significant infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinicians should shift from interpreting CBC parameters based solely on population reference ranges and instead adopt a baseline\u2010informed, trend\u2010based diagnostic approach. In patients with suspected infection, particularly those with normal CBC values or immunosuppression, CRP should be routinely used as an adjunct marker to unmask early or atypical sepsis. In resource\u2010limited settings, where advanced diagnostics are unavailable, integrated interpretation of personalized CBC trends and serial CRP provides a practical, cost\u2010effective strategy to improve diagnostic performance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72145","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T06:49:23Z","timestamp":1774334963000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Personalized Interpretation of CBC and the Role of CRP in Early Detection and Monitoring of Blood Infection or Sepsis: A Diagnostic Perspective"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6547-8707","authenticated-orcid":false,"given":"David","family":"Muhunzi","sequence":"first","affiliation":[{"name":"School of Clinical Medicine Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9886-918X","authenticated-orcid":false,"given":"Emanuel","family":"Mrema","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2713-9957","authenticated-orcid":false,"given":"Fredrick","family":"Banda","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine KCMC University Moshi Tanzania"},{"name":"Department of Epidemiology, School of Public Health KCMC University Moshi Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6012-234X","authenticated-orcid":false,"given":"Harold L.","family":"Mashauri","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine KCMC University Moshi Tanzania"},{"name":"Department of Epidemiology, School of Public Health KCMC University Moshi Tanzania"},{"name":"Department of Clinical Physiology, School of Medicine KCMC University Moshi Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32989-7"},{"key":"e_1_2_14_4_1","unstructured":"WHO \u201cGlobal Report on the Epidemiology and Burden of Sepsis: Current Evidence Identifying Gaps and Future Directions World Health Organization 2020."},{"key":"e_1_2_14_5_1","unstructured":"R.Neviere \u201cUpToDate. Pathophysiology of Sepsis \u201d published 2024 https:\/\/www.uptodate.com\/contents\/pathophysiology-of-sepsis?search=sepsis&topicRef=1657&source=see_link#H1300788."},{"key":"e_1_2_14_6_1","unstructured":"R.Neviere \u201cUpToDate. Sepsis Syndromes in Adults: Epidemiology Definitions Clinical Presentation Diagnosis and Prognosis \u201d published 2025 https:\/\/www.uptodate.com\/contents\/sepsis-syndromes-in-adults-epidemiology-definitions-clinical-presentation-diagnosis-and-prognosis?search=sepsis&topicRef=1597&source=see_link#H1252857377."},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-021-00765-y"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)70112-X"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.08.1460"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19-1696"},{"key":"e_1_2_14_11_1","volume-title":"Laboratory Evaluation of Sepsis","author":"Fulton I. I. M. 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