OBJECTIVE : This study aimed to investigate diagnostic performance of NLR and monocyte percentage associated with clinical scoring in diagnosing PTB in children.
METHOD: This was diagnostic study involving children aged 1 month - 18 years old with presumptive PTB at Saiful Anwar General Hospital, Malang since 2018-2019. Nutritional status, history of TB contact, tuberculin skin test result, radiologic examination and clinical symptom was observed. We also performed complete blood count. WHO clinical criteria was used as reference standard to diagnose PTB. We used SPSS 24.0 to determine cut-off-point value and ROC. Sensitivity and specificity was calculated. Ethical clearance was obtained from Saiful Anwar Hospital’s ethical review board.
 RESULT: Of 95 subjects with 57 (60%) subjects were clinically WHO diagnosed TB and 38 (40%) were not. The NLR cut-off-point was 1.7 (AUC 0.81; 95% CI: 0.71 - 0.90); has a sensitivity of 81% and specificity of 73%; LR(+) 2.9 (95% CI: 1.7-4.8); LR(-) 0.25 (95%CI 0.1-0.4). Monocyte percentage cut-off-point was 6% (AUC 0.83; 95%CI: 0.74-0.92); sensitivity 84% and specificity 76%; LR(+) 3.5 (95% CI: 1.98-6.36); LR(-) 0.2 (95% CI: 0.1-0.3). NLR value combined with clinical scoring TB ? 6  have sensitivity 92% and specificity 84%.
 CONCLUSION: The NLR value has good diagnostic performance and potential to strenghten clinical scoring in diagnosing PTB in children.