Leukocytosis in Negative Malaria Rapid Diagnostic Test Febrile Illness Among Children Under Five Years in a District Hospital

Background: Definitive tests are not routinely available in Ghanaian district hospitals for diagnosing febrile illnesses among childrenunder five years after excluding malaria with the rapid diagnostic test (RDT). Most of such febrile presentations are likely microbial.If an infection-induced WBC elevation is demonstrated consistently enough in such malaria-RDT negative febrile illnesses,it could become a diagnostic aid.Methods: Retrospective data from the clinical records were obtained for ۴۳۲ children from ۶ months to ۵ years of age, who hadpresented with fever (temperature ۳۷.۵°C). Their respectiveWBCcounts were also documented and statistical analysis of the datacarried out.Results: Asignificant relationshipwasdemonstrated between the malaria-RDT negative statusandthe patient’s elevatedWBCcount(P < ۰.۰۰۱). Leukocytosis was absent in ۵۸.۶% of RDT-negative febrile children. Patients who tested RDT-negative were twice as likelyto have elevated WBC counts (OR = ۲.۱۹) than RDT-positive patients.Conclusions: An elevated WBC count has demonstrated a potentially weak relationship with a negative malaria-RDT status amongfebrile children U-۵ in DPH. Standing alone, however, the WBC may not be decisive for the evaluation of U-۵ febrile presentationsafter excluding malaria.

Keywords:

Malaria , Leukocytosis , Febrile Illness