Objective: To determine thediagnostic cut-offs for diagnosis for the neutrophil-lymphocyte ratio (NLR), neutrophil-monocyte ratio (NMR), and monocyte to lymphocyte ratio (MLR) in patients with pulmonary tuberculosis (PTB) and to compare these values with healthy controls who were matched for age and sex over the research period.Methods: A case control study was conducted at Ojha insititute of Chest disease (OICD) & Dr. Irshatul-Ibad Khan insititute of Blood Diseases(DIEKIBD) institute of blood diseases and the Ojha Institute of Diseases in Karachi. A total of 200 participants were taken for study. One hundred (100) adults with a recent PTB diagnosis and one hundred (100) healthy adults who were matched for age and gender took part in the study. Data on hematological, clinical and demographics data were examined. An automated hematology analyzer (SYSMEX XN-9000) was used to perform blood sample analysis. The automated complete blood count (CBC) values were used to compute the NLR, MLR, and NMR ratios. To determine the best diagnostic cut-offs for PTB (AUC), receiver operating characteristic (ROC) analysis was done.Results: The median values of NLR, NMR, and MLR were noticeably greater in PTB individuals as opposed to controls (p 2.88 (AUC = 0.809, Sensitivity = 74%, Specificity = 71.2%), MLR > 0.32 (AUC = 0.928, Sensitivity = 83%, Specificity = 81.4%) and NMR >5.65 (AUC = 0.848, Sensitivity = 84%, Specificity =72.9%) Out of these, MLR showed the highest diagnostic precision (AUC = 0.928).Conclusion: The use of NLR, MLR, and NMR serve as simple, non-invasive, accessible and economical biomarkers that can help in identifying PTB, particularly in low resource settings. Among all three hematological markers, MLR showed the greatest diagnostic accuracy, revealing its potential as a valuable tool for TB screening in settings with restricted resources.
Omair et al. (Tue,) studied this question.