{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T09:24:59Z","timestamp":1774257899851,"version":"3.50.1"},"reference-count":99,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>C-reactive protein (CRP) and procalcitonin (PCT) are widely used biomarkers in high-income countries. However, evidence for their use in low- and middle-income countries (LMICs) is scant. Because many factors, including rates of endemic disease, comorbidities and genetics, may influence biomarkers\u2019 behaviour, we aimed to review available evidence generated in LMICs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched the PubMed database for relevant studies within the last 20\u200ayears that originated in regions of interest (Africa, Latin America, Middle East, South Asia or South East Asia), and full-text articles involving diagnosis, prognostication and evaluation of therapeutic response with CRP and\/or PCT in adults (n\u200a=\u200a88) were reviewed and categorized in 12 predefined focus areas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, results were highly heterogeneous, at times conflicting, and often lacking clinically useful cut-off values. However, most studies demonstrated higher levels of CRP\/PCT in patients with bacterial versus other infections. HIV and TB patients had consistently higher levels of CRP\/PCT versus controls. In addition, higher CRP\/PCT levels at baseline and follow-up in HIV, TB, sepsis and respiratory tract infections were associated with poorer prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Evidence generated from LMIC cohorts suggests that CRP and PCT may have potential to become effective clinical guiding tools particularly in respiratory tract infections, sepsis and HIV\/TB. However, more studies are needed to define potential scenarios for use and cost-effectiveness. Consensus across stakeholders regarding target conditions, laboratory standards and cut-off values would support the quality and applicability of future evidence.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jacamr\/dlad057","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T11:43:25Z","timestamp":1684323805000},"source":"Crossref","is-referenced-by-count":11,"title":["C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3003-8336","authenticated-orcid":false,"given":"Amin","family":"Lamrous","sequence":"first","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Operational Center Barcelona , Barcelona , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernestina","family":"Repetto","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Operational Center Geneva , Geneva , Switzerland"},{"name":"Infectious Diseases Department, Universit\u00e9 Libre de Bruxelles (ULB), CHU Saint-Pierre , Brussels , Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Depp","sequence":"additional","affiliation":[{"name":"Emergency Medicine, University of South Carolina School of Medicine , Greenville, SC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Jimenez","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Operational Center Paris , Paris , France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arlene C","family":"Chua","sequence":"additional","affiliation":[{"name":"Medical Department, M\u00e9decins Sans Fronti\u00e8res\u2014International , Geneva , Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupa","family":"Kanapathipillai","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans 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