# Association of Altered Baseline Hematological Parameters with Adverse Tuberculosis Treatment Outcomes

## TL;DR

This study finds that certain blood cell levels at the start of treatment can predict poor outcomes in tuberculosis patients.

## Contribution

The study identifies baseline hematological parameters as predictors of adverse TB treatment outcomes.

## Key findings

- Altered white blood cell, neutrophil, and monocyte counts are linked to poor TB treatment outcomes.
- Increased neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios are associated with adverse outcomes.
- Lower hematocrit and red blood cell counts are observed in patients with poor treatment outcomes.

## Abstract

Tuberculosis (TB) treatment monitoring is an essential tool for effective TB treatment management. Identifying parameters that predict adverse TB treatment outcomes could significantly improve clinical management. The association of hematological parameters with poor TB treatment outcomes is not well defined. To study the relationship of hematological parameters with TB treatment outcomes, we examined data from pulmonary tuberculosis (PTB) patients with successful (controls) and unsuccessful (cases) treatment outcomes. We enrolled 68 cases and 133 controls through a nested 1:2 case–control study, matching for age, sex, body mass index, diabetes status, alcohol and smoking. Hematological profiling showed significant difference in the absolute counts of white blood cells, lymphocytes, neutrophils and monocytes between cases and controls. In addition, increased neutrophil to lymphocyte ratio (NL) ratio and monocyte to lymphocyte (ML) ratio were present in cases in comparison to controls. Similarly, decreased hematocrit and red blood cell counts were detected in cases when compared with controls. Univariate and multivariate analysis demonstrated a significant association of absolute counts of WBC, neutrophils, monocytes, NL and ML ratios with poor treatment outcomes. The altered baseline hematological parameters are clearly associated with the poor TB treatment outcomes, showing potential for clinical prediction to enhance management of at-risk cases.