Association of baseline white blood cell counts with tuberculosis treatment outcome: a prospective multicentered cohort study.
Int J Infect Dis
; 100: 199-206, 2020 Nov.
Article
em En
| MEDLINE
| ID: mdl-32920230
ABSTRACT
OBJECTIVES:
Tuberculosis (TB) is the leading infectious cause of death in the world. Cheaper and more accessible TB treatment monitoring methods are needed. Here, we evaluated white blood cell (WBC) absolute counts, lymphocyte, and monocyte proportions during TB treatment, and characterized their association with treatment failure.METHODS:
This multicentered prospective cohort study was based in Bangladesh, Georgia, Lebanon, Madagascar, and Paraguay. Adult, non-immunocompromised patients with culture-confirmed pulmonary TB were included and followed up after two months of treatment and at the end of therapy. Blood counts were compared to treatment outcome using descriptive statistics, logistic regression, and Receiver Operating Characteristic (ROC) analyses.RESULTS:
Between December 2017 and August 2020, 198 participants were enrolled, and 152 completed treatment, including 28 (18.5%) drug-resistant patients. The rate of cure at the end of treatment was 90.8% (138/152). WBC absolute counts decreased, and lymphocyte proportions increased throughout treatment. In multivariate analyses, baseline high WBC counts and low lymphocyte proportions were associated with positive sputum culture results at the end of treatment (WBC > 11,450 cells/mm3 p = 0.048; lymphocytes <16.0% p = 0.039; WBC > 11,450 cells/mm3 and lymphocytes <16.0% p = 0.024).CONCLUSION:
High WBC counts and low lymphocyte proportions at baseline are significantly associated with the risk of TB treatment failure.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tuberculose Pulmonar
/
Linfócitos
/
Monócitos
/
Leucocitose
/
Linfopenia
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Africa
/
America do norte
/
America do sul
/
Asia
/
Paraguay
Idioma:
En
Revista:
Int J Infect Dis
Assunto da revista:
DOENCAS TRANSMISSIVEIS
Ano de publicação:
2020
Tipo de documento:
Article