Hematological Abnormalities of Pulmonary Tuberculosis Patients with and without HIV at the University of Gondar Hospital, Northwest Ethiopia: A Comparative Cross-Sectional Study

Abstract

Background Hematological abnormalities are common in pulmonary tuberculosis (PTB) patients, which is one of the major public health problems worldwide. However, there is paucity of information about the hematological profile of PTB patients with and without HIV in the study area. Therefore, this study aimed to assess hematological abnormalities of pulmonary tuberculosis patients with and without HIV at the University of Gondar Hospital, Northwest Ethiopia. Methods A comparative cross-sectional study was conducted at the University of Gondar Hospital. Sociodemographic data was collected using a pretested, structured questionnaire. Five milliliters of venous blood sample was collected and divided into a 3 ml EDTA tube for complete blood count with the Cell Dyn 1800 hematological analyzer and a 2 ml citrated tube for erythrocyte sedimentation rate determination. Data were entered into Epi Info version 3.5.3 and then transferred to SPSS 20 for analysis. The independent samples t-test was used to compare the mean values of hematological parameters between PTB patients and PTB-HIV coinfected patients. Result A total of 100 study subjects (50 PTB and 50 PTB-HIV coinfected) were included with a mean age of 31.3 ± 10.3 years for PTB patients and 32.1 ± 9.2 years for PTB-HIV coinfected patients. In this study, there were significantly lower mean values of Hgb (P = 0.049), platelet count (P < 0.001), and neutrophils counts (P = 0.007) among PTB-HIV coinfected patients when compared with PTB patients. Of the PTB infected patients 46% were anemic, 6% leukopenic, 22% neutropenic, 8% lymphopenic, and 8% thrombocytopenic. On the other hand, of the PTB-HIV coinfected patients 60% were anemic, 14% leukopenic, 66% neutropenic, 12% lymphopenic, and 20% thrombocytopenic. ESR value was increased in all patients. Conclusion This study demonstrated high prevalence of neutropenia, anemia, and thrombocytopenia among PTB-HIV coinfected patients. HIV coinfection worsens hematological abnormalities of PTB patients. Assessment of hematological parameters can be used as an indicator in the diagnosis and follow-up of PTB patients coinfected with HIV. We recommended assessment of PTB patients with or without HIV for various hematological disorders such as neutropenia, anemia, and thrombocytopenia.

Anemia in tuberculosis cases: A biomarker of severity?

“…We found a prevalence of anemia similar to those observed in studies carried out in Asia [ 7 ] and Africa [ 5 , 11 , 13 , 15 , 23 ]. However, Lee et al showed a lower prevalence of anemia in South Korea (31.9%).…”

<p>Evaluation of Peripheral Blood Parameters of Pulmonary Tuberculosis Patients at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: Comparative Study</p>

“…To the best of our knowledge, few studies are available in Ethiopia. Studies done in Jima and Gonder, Ethiopia stated the occurrence of hematological changes in pulmonary tuberculosis patients, 14,15 even though their results are inconsistent in some of the hematological indices. As well, to the best of our knowledge, no study has been conducted in the study area.…”

Association of baseline white blood cell counts with tuberculosis treatment outcome: a prospective multicentered cohort study

“…Neutrophilia and lymphopenia have been associated with higher mortality risks during TB treatment (Lowe et al, 2013). However, many these studies were either small case-control studies (Abay et al, 2018), focused on the risk of developing active TB disease (Kurup et al, 2016), or assessed kinetics during treatment and not association with treatment failure (Morris et al, 1989;Rakotosamimanana et al, 2015). Most available comprehensive studies were in low-burden, high-healthcare standards areas (Ritchie et al, 2016).…”