ASSESSMENT OF NEUTROPHIL TO LYMPHOCYTE RATIO IN PULMONARY TUBERCULOSIS PATIENTS ATTENDING SPECIALIST HOSPITAL, SOKOTO

Abstract

Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains a leading global infectious killer, and systemic inflammation is a major characteristic of its pathophysiology. The Neutrophil to Lymphocyte Ratio (NLR), calculated from a routine Full blood count (FBC), is an inexpensive marker of systemic inflammation and immune status. The aim of this study was to assess the NLR in pulmonary TB patients at Specialist Hospital, Sokoto. Key objectives included determining the baseline NLR in GeneXpert-confirmed pulmonary TB patients and healthy controls and determining the potential of baseline. A total of 150 participants were recruited: 75 newly diagnosed GeneXpert-confirmed pulmonary TB patients and 75 apparently healthy controls. NLR was calculated as the ratio of absolute neutrophil count to absolute lymphocyte count. Data analysis utilized Student's t-test and chi-square statistics, with a p-value < 0.05 indicating statistical significance. The mean baseline NLR for the GeneXpert-confirmed pulmonary TB subject was 1.69±1.72. This NLR value was highly significantly greater than the mean baseline NLR for the apparently healthy control subject, which was 0.76±0.38 (P=0.0001). Furthermore, when comparing low, moderate, and high categorized NLR levels across all subjects, the differences in means were also highly significant (P=0.0001). Categorized NLR levels showed statistically significant associations with TB status, age, and smoking history (P<0.05). The baseline NLR is significantly elevated in active pulmonary TB patients compared to healthy individuals. NLR, derived from routine testing, should be considered for integration into clinical algorithms for patient stratification and monitoring, particularly in resource-limited setting.