Longitudinal assessment of the impact of tuberculosis infection and treatment on monocyte–lymphocyte ratio, neutrophil–lymphocyte ratio, and other white blood cell parameters

Okeke,; Amilo, GI; Ifeanyichukwu, Martin; Obi, Ejeatuluchukwu

doi:10.4103/ejh.ejh_62_19

Cited by 3 publications

(8 citation statements)

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“…Since it is a cheap, readily available, and reproducible test, the MLR can be considered as an independent prognostic marker and a reliable tool to evaluate treatment success in TB infection. [25] The result of this meta-analysis should be interpreted with the following limitations in mind: Heterogeneity was observed in the included studies, and this may be due to the inclusion of studies only in the English language.…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

“…[6] A total of 15 studies were included in this systematic review and meta-analysis to investigate the accuracy of MLR for the diagnosis of TB and also its role in monitoring anti-TB therapy. [22] Egypt 50 50 0.46 ± 0.30 0.15 ± 0.06 80 90 Ngahane et al 2019 [24] Cameroon 204 204 0.39 ± 0.23 0.19 ± 0.11 67.2 83.3 Manna et al 2017 [3] Italy 31 71 0.50 ± 0.20 0.18 ± 0.06 91.04 93.55 Liana et al 2019 [23] Indonesia 41 60 0.97 ± 0.51 0.57 ± 0.76 95.1 70 Rakotosamimanana et al 2015 [20] Madagascar 85 186 --4.97 (1.3-18.99) Rees et al 2020 [26] Tanzania 98 47 --68 51 Choudhary et al 2019 [18] Kenya 13 67 0.48 ± 0.3 0.23 ± 0.2 77 78 Naranbhai et al2014 [17] South Africa* 12 1190 --1.22 (1.07-1.4) Naranbhai et al2014 [11] South Africa 1862 --2.47 (1.39-4.40) Ginderdeuren et al 2021 [19] South Africa 51 120 0.22 ± 0.16 0.34 ± 0.27 0.78 (0.59, 0.97) Naranbhai et al2014 [12] South Africa 1336 -1.23 (1.04-1.45) MLR before treatment MLR after treatment Wang et al 2015 [8] China 419 327 0.47 ± 0.21 0.22 ± 0.09 Iqbal et al 2014 [21] Pakistan 45 45 0.24 ± 0.14 0.19 ± 0.10 Okeke et al 2020 [25] Nigeria 60 60 0.11 ± 0.08 0.08 ± 0.06 Wang et al 2019 [9] China 151 129 0.47 ± 0.29 0.34 ± 0.5 In this study, a significant increase in MLR was observed among TB patients compared to controls (SMD = 0.69; 95% CI, 0.37-1.01). It has been reported that circulating monocytes from patients with TB exhibit phenotypic and functional alterations compared with healthy controls.…”

Section: Discussionmentioning

confidence: 99%

“…Four studies showed the role of MLR in monitoring anti-TB therapy in the form of mean and SD. Five studies were conducted in HIV-AIDS patients at risk of developing MTB, [11,12,[17][18][19] 1 study in household TB contacts, [20] and the remaining 9 studies [3,8,9,[21][22][23][24][25][26] were conducted in MTB patients (Table 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Accuracy of monocyte to lymphocyte ratio for tuberculosis diagnosis and its role in monitoring anti-tuberculosis treatment: Systematic review and meta-analysis

et al. 2022

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Background: High monocyte to lymphocyte ratio (MLR) values may be associated with the risk of active tuberculosis (TB) infection in adults, infants, and postpartum women with HIV infection. It may also serve as an indicator of the effectiveness of anti-TB treatment. Thus, the main aim of this study is to ascertain the accuracy of MLR for the diagnosis of TB and its role in monitoring the effectiveness of anti-TB therapy.Methods: This systematic review and meta-analysis followed the preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. All statistical analyses were performed using STATA 11 and Meta-DiSc software. The Quality assessment of Diagnostic Accuracy Studies tool was used to evaluate the methodological quality of the included studies. The area under the hierarchical summary receiver-operating characteristic hierarchical summary ROC curve [(HSROC) curve (AUC)] was also calculated as an indicator of diagnostic accuracy.Results: A total of 15 articles were included in this study. Accordingly, the result showed that elevated MLR is associated with increased risks of TB disease [odd ratio = 3.11 (95% CI: 1.40-6.93)]. The pooled sensitivity and specificity of MLR for identifying TB were 79.5% (95% CI: 68.5-87.3) and 80.2% (95% CI: 67.3-88.9), respectively. The AUC of HSROC was 0.88 (95% CI: 0.857-0.903), indicating the excellent diagnostic performance of MLR for TB. This study also showed that there is a significant reduction in the MLR value after anti-TB treatment in TB patients (standardized mean difference = 0.68; 95% CI: 0.007, 1.43).Conclusions: Generally, MLR can be considered as a crucial biomarker to identify TB and monitor the effectiveness of anti-TB therapy.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Accuracy of monocyte to lymphocyte ratio for tuberculosis diagnosis and its role in monitoring anti-tuberculosis treatment: Systematic review and meta-analysis

et al. 2022

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“…MLR and NLR are expected to be elevated during active disease and normalize with effective treatment, serving as predictive tools for TB [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship of neutrophil lymphocyte ratio, monocyte lymphocyte ratio and neutrophil monocyte ratio with treatment response in pulmonary tuberculosis patients during intensive phase treatment

Omair,

Baig,

Farooqui

et al. 2024

BMC Infect Dis

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Objective To determine the relationship of Neutrophil Lymphocyte Ratio (NLR), Monocyte Lymphocyte Ratio (MLR), and Neutrophil Monocyte Ratio (NMR) with treatment response in Pulmonary Tuberculosis (PTB) patients during intensive phase treatment (IPT). Methods This analytical cross-sectional study was conducted at Ojha Institute of Chest Diseases (OICD), Dow University of Health Sciences, from February to December 2021. 100 patients were enrolled using purposive sampling technique. Both male and female of age 18 and above, rifampicin sensitive newly diagnosed cases of PTB by Acid Fast Bacilli (AFB) microscopy and Gene Xpert MTB/RIF were included. SPSS version 26 was used to analyze data. Numerical data was expressed in median and interquartile range and categorical data was expressed in frequencies and percentages. Results Out of total 100 patients, 81% (n = 81) showed treatment response with negative AFB Sputum Smear Microscopy (SSM) after 2nd month. Out of 81% (n = 81) of the patients who achieved treatment response, 83.9% (n = 68) also had decreased NLR, 85.2% (n = 69) had decreased MLR and 83.9% (n = 68) had decreased NMR from baseline. However 19% (n = 19) did not achieved treatment response with positive AFB SSM after 2nd month of ATT (Anti tuberculosis treatment), among them 10.52% (n = 2) were INH resistant with no decrease in all the ratios after 2nd month. Conclusion Leukocyte ratios decreased significantly from baseline as PTB was treated in patients who achieved treatment response with negative AFB SSM after two months of ATT and hence these ratios could be used as markers to monitor the treatment response.

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Deciphering the significance of neutrophil to lymphocyte and monocyte to lymphocyte ratios in tuberculosis: A case-control study from southern India

Bakshi,

Nayak,

Rai

et al. 2024

F1000Res

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Background Diagnosis of tuberculosis (TB) in resource-limited countries relies primarily on bacteriological confirmation using Ziehl-Neelsen (ZN) stain or culture. However, this method has low sensitivity due to suboptimal sampling and techniques. Neutrophils, monocytes, and lymphocytes are crucial in the pathogenesis of granulomatous inflammation and immune reactions. We investigated the usefulness of the haematological parameters and their ratios, like the Neutrophil to Lymphocyte ratio (NLR) and Monocyte to Lymphocyte ratio (MLR), for diagnosing tuberculosis. Methods We retrospectively grouped 114 patients with fever into those diagnosed with TB and control groups. We obtained their haematological data and calculated their derived ratios. The ratios obtained from the two groups were compared. Their sensitivity and specificity were calculated. Results Haematological parameters like MLR were higher in TB patients than in the control group. Although NLR was not significantly increased, MLR was significantly increased with p values <0.05. These tests had low sensitivity but high specificity. Conclusion Serum NLR and MLR emerge as valuable tools in TB diagnosis. Their simplicity and cost-effectiveness render them particularly suitable for screening and recurrence monitoring in rural and remote settings, thereby mitigating loss to follow-up.

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Longitudinal assessment of the impact of tuberculosis infection and treatment on monocyte–lymphocyte ratio, neutrophil–lymphocyte ratio, and other white blood cell parameters

Cited by 3 publications

References 1 publication

Accuracy of monocyte to lymphocyte ratio for tuberculosis diagnosis and its role in monitoring anti-tuberculosis treatment: Systematic review and meta-analysis

Accuracy of monocyte to lymphocyte ratio for tuberculosis diagnosis and its role in monitoring anti-tuberculosis treatment: Systematic review and meta-analysis

Relationship of neutrophil lymphocyte ratio, monocyte lymphocyte ratio and neutrophil monocyte ratio with treatment response in pulmonary tuberculosis patients during intensive phase treatment

Deciphering the significance of neutrophil to lymphocyte and monocyte to lymphocyte ratios in tuberculosis: A case-control study from southern India

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