{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T21:18:26Z","timestamp":1788988706070,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T00:00:00Z","timestamp":1691971200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Higher number of monocytes and neutrophils may correlate with active tuberculosis (TB) in children. However, the few paediatric studies available are limited by the small numbers of children with TB disease or infection included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We calculated the monocyte\u2010to\u2010lymphocyte\u2010ratio (MLR), neutrophil\u2010to\u2010lymphocyte\u2010ratio (NLR) and neutrophil\u2010to\u2010monocyte\u2010plus\u2010lymphocyte\u2010ratio (NMLR) in children with active TB, latent TB infection (LTBI), other infectious and non\u2010infectious conditions and healthy children evaluated in two referral centres in Rome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 649 children were included (41.8% females, mean age of 5.74\u2009years). MLR, NLR and NMLR values were always significantly higher in patients with TB compared with the other groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Considering the entire population with the outcome of TB diagnosis, NMLR, with a cut\u2010off of 1.2, had a sensitivity of 63% and a specificity of 76% (AUC: 0.71 [0.64\u20130.78]); NLR, with a cut\u2010off of 1.5, had a sensitivity of 61% and a specificity of 79% (AUC: 0.72 [0.65\u20130.79]); MLR, considering a cut\u2010off of 0.2, was less sensitive (56%) but more specific (82%) with a similar AUC (0.72 [0.65\u20130.79]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study provides further evidence that MLR, NLR and NMLR can serve as first level diagnostics to support the clinical suspicion of TB in children.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.16932","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T21:03:50Z","timestamp":1691183030000},"page":"2418-2425","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Monocyte\u2010to\u2010lymphocyte, neutrophil\u2010to\u2010lymphocyte and neutrophil\u2010to\u2010monocyte plus lymphocyte ratios in children with active tuberculosis: A multicentre study"],"prefix":"10.1111","volume":"112","author":[{"given":"Laura","family":"Cursi","sequence":"first","affiliation":[{"name":"Infectious Disease Unit Bambino Ges\u00f9 Children's Hospital, Hospital University Pediatrics Clinical Area (APUO), IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lancella","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit Bambino Ges\u00f9 Children's Hospital, Hospital University Pediatrics Clinical Area (APUO), IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1142-6678","authenticated-orcid":false,"given":"Francesco","family":"Mariani","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Martino","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca","family":"Leccese","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Di\u00a0Giuseppe","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit Bambino Ges\u00f9 Children's Hospital, Hospital University Pediatrics Clinical Area (APUO), IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Venuti","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit Bambino Ges\u00f9 Children's Hospital, Hospital University Pediatrics Clinical Area (APUO), IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russo","family":"Cristina","sequence":"additional","affiliation":[{"name":"Virology and Mycobacteria Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonarda","family":"Gentile","sequence":"additional","affiliation":[{"name":"Virology and Mycobacteria Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Sali","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie\u2010Sezione di Microbiologia Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Delogu","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie\u2010Sezione di Microbiologia Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Valentini","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8567-2639","authenticated-orcid":false,"given":"Danilo","family":"Buonsenso","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"},{"name":"Centro di Salute Globale Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,14]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Global tuberculosis report 2022.World Health Organization;2022.https:\/\/www.who.int\/teams\/global\u2010tuberculosis\u2010programme\/tb\u2010reports"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/1040841X.2016.1262813"},{"key":"e_1_2_9_4_1","volume-title":"Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children","year":"2014"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002824"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214289"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-023-04844-1"},{"key":"e_1_2_9_8_1","first-page":"231","article-title":"The role of the monocyte in tuberculosis","volume":"4","author":"Sabin FR","year":"1925","journal-title":"Bull Johns Hopkins Hosp"},{"key":"e_1_2_9_9_1","unstructured":"SabinFR DoanCA CunninghamRS.Studies of the blood in experimental tuberculosis: the monocyte\u2010lymphocyte ratio; the anemia\u2010leucopenia phase. 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