{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T10:40:05Z","timestamp":1756118405227,"version":"3.44.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"German Federal Ministry of Education and Research","award":["031L0286B"],"award-info":[{"award-number":["031L0286B"]}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["IRTG 2290"],"award-info":[{"award-number":["IRTG 2290"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The clinical presentation of individuals infected with Plasmodium falciparum is exceptionally diverse, ranging from asymptomatic parasitemia to life-threatening disease. Frequent previous exposure to Plasmodium spp results in partial protection from severe disease; however, this protection wanes in individuals emigrating from holoendemic regions, and there are currently no reliable biomarkers that accurately indicate this semi-immunity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data were analyzed from 1392 adults infected with P falciparum in Gabon and Germany. Full blood count parameters and ratios were evaluated individually and as a combined ensemble-based machine learning classifier to predict disease severity, ranging from asymptomatic infection to severe malaria. As a secondary objective, the influence of previous exposure to Plasmodium spp was assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Comparing asymptomatic parasitemia with uncomplicated malaria in Gabonese and comparing uncomplicated with severe malaria in German patients revealed significantly lower platelet counts (218 vs 150 \u00d7103\/\u00b5L, P &amp;lt; .0001; 85 vs 40 \u00d7103\/\u00b5L, P &amp;lt; .0001, respectively) and higher neutrophil counts (2.32 vs 2.57 \u00d7103\/\u00b5L, P = .0037; 3.08 vs 4.49 \u00d7103\/\u00b5L, P &amp;lt; .0001) in those with greater infection severity. The machine learning classifier outperformed single parameters in differentiating infection severity in both comparisons (area under the receiver operating characteristic curve, 0.94 and 0.84). Lymphocyte and monocyte counts showed a pattern that follows the level of previous malaria exposure, with lower cell counts in naive vs previously exposed patients, regardless of infection severity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The value of simple full blood count parameters for classification of P falciparum infection severity and previous exposure is considerable. The accuracy can be increased by integrating individual parameters into a joint machine learning model.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf421","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T18:07:48Z","timestamp":1752775668000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparative Analysis of Initial Full Blood Count Parameters in Adults Infected With <i>Plasmodium falciparum<\/i> for Classification of Disease Severity and Previous Exposure Across Endemic (Gabon) and Nonendemic (Germany) Settings"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3391-3191","authenticated-orcid":false,"given":"C\u00e4cilie","family":"von Wedel","sequence":"first","affiliation":[{"name":"Department of Clinical Research, Centre de Recherches M\u00e9dicales de Lambar\u00e9n\u00e9 , Lambar\u00e9n\u00e9 ,","place":["Gabon"]},{"name":"Department of Infectious Diseases and Critical Care Medicine, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1956-2946","authenticated-orcid":false,"given":"Lars Christian","family":"Matthies","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Centre de Recherches M\u00e9dicales de Lambar\u00e9n\u00e9 , Lambar\u00e9n\u00e9 ,","place":["Gabon"]},{"name":"Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4560-8939","authenticated-orcid":false,"given":"Clemens","family":"Dierks","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Critical Care Medicine, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]},{"name":"Institute of Biochemistry, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9148-3663","authenticated-orcid":false,"given":"Pinkus","family":"Tober-Lau","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Critical Care Medicine, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5302-9507","authenticated-orcid":false,"given":"Lara","family":"Bardtke","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Critical Care Medicine, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5377-3152","authenticated-orcid":false,"given":"Tilman","family":"Lingscheid","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Critical Care Medicine, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin , Berlin ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara","family":"Nordmann","sequence":"additional","affiliation":[{"name":"Center for Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and I. 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