Inflammatory Profiles in Young, University-Affiliated Conflict-Affected Adults: Neutrophilto- Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and C-Reactive Protein in Displaced and Non-Displaced Yemeni Adults

Naif Taleb Ali¹, Mansour Abdulnabi H. Mehdi², Radfan Saleh Abdullah¹,², Nazeh Mohammed Al-Abd¹,³, Ali N. M. Gubran¹

Keywords: Inflammation, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, C-reactive protein, displacement, conflict, Yemen, biomarkers

DOI: 10.63475/yjm.v5i1.0348

DOI URL: https://doi.org/10.63475/yjm.v5i1.0348

Publish Date: 17-04-2026

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Author Affiliation:

1 Assistant Professor, Department of Health Sciences, Faculty of Medicine and Health Sciences, University of Science and Technology, Aden, Yemen
2 Assistant Professor, Department of Laboratory Sciences, Radfan College University, University of Lahej, Al-Houta, Yemen
3 Assistant Professor, Department of Para-Clinic, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen

Abstract

Background: Armed conflict and displacement create chronic inflammatory states that may be reflected in routine hematological parameters. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are emerging low-cost inflammatory markers, but their utility in conflict-affected populations remains unexplored. This study aimed to compare inflammatory markers (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR], NLR, PLR, and mean platelet volume [MPV]) between displaced and non-displaced individuals in conflict-affected Southern Yemen and to identify factors associated with elevated inflammatory markers.

Methods: A cross-sectional study was conducted between September and November 2025 among 830 participants from four academic institutions in Southern Yemen. Complete blood count parameters, including NLR, PLR, and MPV, were analyzed using automated analyzers. CRP and ESR were measured as inflammatory markers. Displacement status was categorized as nondisplaced (n=451), previously displaced (n=257), and currently displaced (n=122). Multivariate logistic regression identified factors independently associated with elevated NLR (>3.0).

Results: Currently displaced participants had significantly higher median CRP (4.2 mg/L vs. 3.1 mg/L; P < 0.001), NLR (4.3 vs. 3.7; P = 0.001), PLR (2.2 vs. 1.7; P = 0.002), and MPV (14.1 fL vs. 13.4 fL; P < 0.001) compared to non-displaced individuals. The prevalence of elevated NLR (>3.0) increased progressively from non-displaced (46.6%) to previously displaced (54.1%) to currently displaced participants (63.9%; P = 0.001). In multivariate analysis, current displacement (adjusted odds ratio [AOR] = 2.23, 95% CI: 1.48–3.36, P < 0.001), severe war exposure (AOR = 1.89, 95% CI: 1.32–2.71, P < 0.001), and elevated CRP (AOR = 1.67, 95% CI: 1.19–2.34, P = 0.003) were

independent predictors of elevated NLR.

Conclusions: Displacement and war exposure are independently associated with elevated inflammatory markers (NLR, PLR, CRP, MPV) in a cohort of young, university-affiliated Yemeni adults. These low-cost parameters may serve as accessible biomarkers for monitoring inflammatory status in similar humanitarian settings, although findings require validation in broader, more representative conflict-affected populations.

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