{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T01:52:42Z","timestamp":1773712362783,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T00:00:00Z","timestamp":1587686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100001732","name":"Danish National Research Foundation","doi-asserted-by":"publisher","award":["DNRF108"],"award-info":[{"award-number":["DNRF108"]}],"id":[{"id":"10.13039\/501100001732","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004046","name":"Karen Elise Jensens Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004046","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Manual white blood cell (WBC) differential counts as a predictor for neonatal sepsis development in a low-resource setting have not been thoroughly evaluated. We hypothesized that manual differentiation (specifically immature:total [I:T] neutrophil ratios) would be feasible and useful as an adjunct to predict early-onset neonatal sepsis (EONS). Secondarily, we hypothesized that vaccination with bacillus Calmette-Gu\u00e9rin (BCG) and oral polio vaccine (OPV) could alter WBC differential counts and thus might reduce its predictive performance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a prospective cohort study within a randomized trial, randomizing healthy, high-risk newborns admitted to the nursery at the national hospital in Guinea-Bissau 1:1 to BCG+OPV at admission or at discharge (usual practice). Thin capillary blood films were prepared at 2\u00a0d of age in a subset of 268 neonates. WBC counts were assessed by microscopy and neonates were followed up for sepsis development within 2\u00a0weeks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Ninety-eight percent (264\/268) of smears provided interpretable reads. Of the 264 children, 136 had been randomized to receive BCG+OPV prior to sampling; the remaining 128 were vaccinated at discharge. The I:T ratio (average 0.017) was lower among children who did not develop clinical sepsis but did not predict sepsis (p=0.70). Only three children had an I:T ratio &amp;gt;0.2 (associated with a higher probability of clinical sepsis in previous studies) but did not develop sepsis. Immunization did not alter WBC composition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Manual WBC differentials are feasible in low-resource settings. WBC differentials are not affected by standard newborn immunization. However, the I:T ratio had no value in predicting subsequent development of sepsis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/trstmh\/traa023","type":"journal-article","created":{"date-parts":[[2020,3,15]],"date-time":"2020-03-15T20:24:41Z","timestamp":1584303881000},"page":"566-574","source":"Crossref","is-referenced-by-count":5,"title":["Feasibility of manual white blood cell counts as a predictor of neonatal sepsis in a low-resource setting"],"prefix":"10.1093","volume":"114","author":[{"given":"Christian N","family":"Golding","sequence":"first","affiliation":[{"name":"Bandim Health Project , Indepth Network, Apartado 861, Bissau 1004,","place":["Guinea-Bissau"]},{"name":"Institute of Health , Aarhus University, Nordre Ringgade 1, Aarhus C 8000,","place":["Denmark"]},{"name":"Research Center for Vitamins and Vaccines , Statens Serum Institut, Artillerivej 5, Copenhagen S 2300,","place":["Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederik","family":"Schaltz-Buchholzer","sequence":"additional","affiliation":[{"name":"Bandim Health Project , Indepth Network, Apartado 861, Bissau 1004,","place":["Guinea-Bissau"]},{"name":"Research Center for Vitamins and Vaccines , Statens Serum Institut, Artillerivej 5, Copenhagen S 2300,","place":["Denmark"]},{"name":"OPEN , Department of Clinical Research, University of Southern Denmark, and Odense University Hospital, J.B. Winsl\u00f8ws Vej 9A, Odense C 5000,","place":["Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilica","family":"Sanca","sequence":"additional","affiliation":[{"name":"Bandim Health Project , Indepth Network, Apartado 861, Bissau 1004,","place":["Guinea-Bissau"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Clipet-Jensen","sequence":"additional","affiliation":[{"name":"Research Center for Vitamins and Vaccines , Statens Serum Institut, Artillerivej 5, Copenhagen S 2300,","place":["Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine S","family":"Benn","sequence":"additional","affiliation":[{"name":"Bandim Health Project , Indepth Network, Apartado 861, Bissau 1004,","place":["Guinea-Bissau"]},{"name":"Research Center for Vitamins and Vaccines , Statens Serum Institut, Artillerivej 5, Copenhagen S 2300,","place":["Denmark"]},{"name":"OPEN , Department of Clinical Research, University of Southern Denmark, and Odense University Hospital, J.B. Winsl\u00f8ws Vej 9A, Odense C 5000,","place":["Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Au","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine , University of British Columbia, Rm. G227\u20132211 Wesbrook Mall, Vancouver, BC Canada V6T 2B5"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Chipperfield","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine , University of British Columbia, Rm. G227\u20132211 Wesbrook Mall, Vancouver, BC Canada V6T 2B5"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias R","family":"Kollmann","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , University of British Columbia, Rm 2D19, 4480 Oak Street, Vancouver, BC Canada V6H 3V4"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelly A","family":"Amenyogbe","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine , University of British Columbia, 2775 Laurel Street, Vancouver, BC Canada V5Z 1M9"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,4,24]]},"reference":[{"issue":"10010","key":"2024102110201742500_ref1","doi-asserted-by":"crossref","first-page":"2275","DOI":"10.1016\/S0140-6736(15)00120-8","article-title":"Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a 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