Longitudinal Assessment Of The Impact Of Tuberculosis Infection And Treatment On Monocyte-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio, And Other White Blood Cell Parameters

Context Tuberculosis (TB) is a major infectious disease usually marked by alterations in white blood cell (WBC) parameters which are known to play a major role in the normal body response to infections. Aim The aim was to assess the impact of TB infection and treatment on monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and other WBC parameters in TB individuals before and in the course of therapy. Settings and design This was a longitudinal follow-up study that included 60 TB-infected individuals, age 18 and 80 years. The TB individuals were recruited at Mile-Four Hospital Abakaliki before initiation of therapy and followed up at 2 months and 6 months into treatment. Materials and methods TB diagnosis was done using both Ziehl-Neelsen acid fast bacilli test and GeneXpert Mycobacterium tuberculosis/rifampicin assay. Whole blood collected in dipotassium ethylenediamine tetraacetic acid was used for the measurement of total white blood cell count and differential white cell count (neutrophil, lymphocyte, monocyte, eosinophil) and packed cell volume. The MLR and NLR were calculated. Statistical Package for the Social Sciences (SPSS), version 22 was used for statistical analysis. Results The findings showed that total white cell count, neutrophil count, lymphocyte count, eosinophil count, and monocyte count (x109/l) were all significantly decreased after 2-month treatment compared with the pretreatment values (P<0.05) and all except monocyte was significantly increased after 6-month treatment (P<0.05). There was a significant decrease in NLR and MLR after 2 months of treatment that was maintained after 6 months of treatment. Moreover, the packed cell volume (l/l) increased significantly after 2 months of treatment and decreased significantly after 6 months of treatment. Conclusion TB is associated with significant changes in NLR, MLR, and other WBC parameters which might be possible markers to explore as a prognostic index in TB disease.