EP318 - THE MONOCYTE TO LYMPHOCYTE AND NEUTROPHIL TO LYMPHOCYTE RATIO AS DIAGNOSTIC, PROGNOSTIC AND TREATMENT MARKER FOR TUBERCULOSIS; A SYSTEMATIC REVIEW (ID 545)
Abstract
Backgrounds:
The monocyte to lymphocyte (MLR) and neutrophil to lymphocyte (NLR) ratio were described to be associated several inflammatory conditions and infections. The aim of this study was to systematically review the literature for MLR and NLR as prognostic, diagnostic and treatment marker for tuberculosis (TB).
Methods
The literature search was done on OVID for Medline and Embase, and in the Cochrane library on 22 January 2021. The following search terms and strategy were used: tuberculosis AND (monocyte OR neutrophils), AND lymphocytes, AND (diagnostic OR prognostic OR treatment).
Results:
A total of 1617 studies were identified, of which 31 studies were included in the final analysis. Eight studies included children and four studies included patients living with HIV. Most compared individuals with TB disease (TBD) to those with TB infection (LTBI) or healthy controls, while comparison of MLR and NLR in TBD to sick controls was reported in only 3 and 6 studies, respectively. Studies enrolled a median of 153 (IQR 118 to 280) individuals. MLR and NLR were assessed in 17 and 19 studies, respectively. A total 30 data sets for MLR and 30 for NLR were extracted.
An increased MLR and NLR were associated TBD when compared to healthy controls and individuals with LTBI. MLR was shown to be a prognostic marker for progression to TBD. MLR decreased with TB treatment. The cut-offs determined in the studies were highly variable for MLR and NLR, and prevented a meta-analysis of sensitivity and specificity.
Conclusions/Learning Points:
A higher MLR and NLR is associated with TBD and therefore may be easily used as additional diagnostic markers at low-cost. Further studies investigating these markers across symptomatic presumptive cases with and without TBD are required.
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