The diagnostic significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in malaria: insights and implications - a narrative review.

Malaria remains a significant global health challenge, necessitating accurate diagnostic tools for timely intervention and effective management. This review explores the diagnostic significance of two hematological biomarkers, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), in the context of malaria. These ratios, derived from routine complete blood count parameters, offer insights into systemic inflammation and immune response dynamics, contributing valuable information for assessing disease severity and predicting clinical outcomes. The NLR and PLR have emerged as promising indicators of malaria severity, reflecting the host's immune response and inflammatory state during infection. Elevated NLR levels are associated with severe malaria manifestations, including cerebral involvement and organ dysfunction, indicative of dysregulated immune activation characterized by heightened neutrophil activity and lymphocyte depletion. Conversely, alterations in PLR suggest platelet consumption and immune-mediated thrombocytopenia, which correlate with disease progression and complications. Integrating NLR and PLR into malaria diagnostic algorithms holds potential benefits for clinical practice, particularly in resource-limited settings where access to sophisticated diagnostic tools may be constrained. Rapid calculation from standard complete blood count results facilitates timely risk assessment and treatment decision-making, complementing existing diagnostic methods like rapid diagnostic tests and microscopy. Furthermore, longitudinal monitoring of NLR and PLR dynamics during treatment provides valuable insights into therapeutic response and disease resolution, aiding in patient management strategies aimed at optimizing outcomes and reducing mortality rates associated with severe malaria.