Cell Population Data Parameters in Dengue-Is There Any Significance? A Single-Center Study

To assess the significance of cell population data parameters (CPD) in dengue positive individuals.

A retrospective cross-sectional study was conducted at the National Institute of Blood Disease and Bone Marrow Transplantation (NIBD and BMT), Karachi, Pakistan from July 2022 to September 2022 (in a period of 3 months of peak dengue fever outbreak). Dengue fever is a viral infection that is transmitted from mosquitoes to humans. It is more prevalent in tropical and subtropical environments. A total of 389 individuals, who presented with febrile illness at the NIBD clinics, were screened for dengue and malaria with Complete Blood Count (CBC), Dengue nonstructural protein 1 (NS1) antigen test and Malaria Parasite Immunochromatographic test (MP-ICT). Whole blood samples were collected and analyzed for CBC on Sysmex XN hematology analyzers. All 65 CPD and standard CBC parameters were analyzed. Statistical analysis was performed using SPSS version 25.0. Descriptive analysis of all the parameters was performed and a p value < 0.001 was considered significant. Positive and negative correlation was also evaluated within the parameters to assess their significance. Furthermore, cut-off values of CPD parameters were evaluated plotting their receiver operating characteristic (ROC) curves.

Out of the 389 febrile patients, 137 were diagnosed as dengue-positive. Descriptive analysis for mean and median values of parameters revealed statistically significant difference for seven parameters (namely WBC, PLT-F, NEUT, LYMP, MONO, HFLC, and LY-WY) in the comparison of the two groups which were then further assessed for positive and negative correlation. Multivariate logistic regression analysis revealed High Fluorescence Lymphocyte Count (HFLC) to be the distinguishing parameter among dengue positive and negative cases. Compared to all the CPD parameters of our data set, the area under curve for lymphocytes cell size and the width of dispersion (LY-WZ) displayed a borderline value of 0.582.

Sysmex XN hematology analyzers can provide extensive information about CPD parameters, allowing for the prompt differentiation among febrile illnesses and dengue infection. HFLC and other significant parameters demonstrate promise as rapid, adjunctive diagnostic tools. Further research is needed to validate these findings and optimize the clinical utility of CPD parameters in dengue management.