Blood Neutrophil Count, Sputum Mycobacterial Load and Mycobacterial Lineages in HIV Positive Individuals Suspected with Pulmonary Tuberculosis, Addis Ababa, Ethiopia

Debela, Negeri (2015) Blood Neutrophil Count, Sputum Mycobacterial Load and Mycobacterial Lineages in HIV Positive Individuals Suspected with Pulmonary Tuberculosis, Addis Ababa, Ethiopia. Masters thesis, Addis Ababa University.

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Abstract

Background: The protective and pathologic response of host to M.tuberculosis is complex and multifaceted, involving many components of the immune system. There are evidences which suggest that neutrophils play a role in the host response to M.tuberculosis. In patients with established tuberculosis (TB) disease, higher peripheral blood neutrophil counts are associated with delayed mycobacterial clearance from sputum and worse clinical prognosis. Objective: To determine neutrophil counts in peripheral blood of HIV positive individuals with suspected pulmonary tuberculosis(PTB) and to find out the association with mycobacterial load and mycobacterial lineage in Zewoditu-Memorial Hospital and Federal Police Hospital, Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted from January 2014 to July 2014. EDTA (Ethylene Diamine Tetra Acetic Acid) anti-coagulated venous blood and sputum samples were obtained. Blood absolute neutrophil counts (ANC) were determined using Cell Dyn 1800 automated hematology analyzer. Sputum samples were decontaminated using sodium hydroxide, which were then concentrated by centrifugation. Smears were prepared from the pellet and stained with ZN (Ziehl-Neelsen) stain for microscopy. The remaining sputum pellets were then used for culture, using LJ (Lowenstein-Jensen) medium. Isolates were also heat killed for molecular genotyping and characterized using spoligotyping. Statistical analyses were done using SPSS and statistical tests were significant at p<0.05. Result: Among 117 participants, the median blood neutrophil count was 2.70x103cells/µl (IQR, 2.1–3.7). PTB was confirmed in 28 out of 117 participants. Patients with PTB had a median blood neutrophil count of 4.06x103/µl (IQR, 3.22–5.91) compared to 2.56x103 cells /µl (IQR, 2.1–3.1) among those who were PTB negative (p<0.05). Participants with low mycobacterial load had median ANC values of 3.5x103cells/µl (IQR, 2.6–4.2) and those participants with high mycobacterial burdens had ANC values of 5.5x103cells/µl (IQR, 3.9–7.4) (p<0.05). Participants infected with modern mycobacterial lineage had higher blood ANC than those infected with ancient lineage (p=0.41). Conclusions: Increased blood neutrophil counts were observed among PTB positive individuals and among individuals with high sputum mycobacterial load.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Neutrophils count, HIV, Pulmonary tuberculosis, sputum mycobacterial load, mycobacterial lineage
Subjects: Q Science > QR Microbiology
Q Science > QR Microbiology > QR180 Immunology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Africana
Depositing User: Emmanuel Ndorimana
Date Deposited: 27 Nov 2018 13:21
Last Modified: 27 Nov 2018 13:21
URI: http://thesisbank.jhia.ac.ke/id/eprint/7740

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