White Blood Cell Differential Count in Pulmonary Tuberculosis Patients at the Chest Diseases Hospital, Gombe State, North East Nigeria

This study examines white blood cell differential count patterns in newly diagnosed pulmonary tuberculosis (PTB) patients at the Chest Diseases Hospital, Gombe State, located in Nigeria's North East geopolitical zone. Tuberculosis produces distinct immunological responses reflected in peripheral blood leucocyte dynamics, and understanding these changes aids in monitoring treatment response and identifying complications. A cross-sectional study compared differential leucocyte counts of 150 newly diagnosed, sputum-confirmed PTB patients with 75 apparently healthy controls matched by age and sex. Full blood count and manual differential counts were performed on Giemsa-stained peripheral blood films. HIV co-infection status was determined for all participants. Findings revealed significant lymphopenia, elevated neutrophil-to-lymphocyte ratio (NLR), and monocytosis in PTB patients compared to controls. HIV-co-infected TB patients showed more pronounced lymphopenia and a significantly higher NLR. Anaemia was present in 62 percent of TB patients, predominantly normocytic normochromic in pattern. A statistically significant correlation was found between NLR and sputum bacillary load, suggesting NLR as a practical surrogate marker of disease severity accessible even in resource-limited settings. The study recommends routine full blood count and differential analysis at TB diagnosis and at monthly intervals during treatment in Gombe State, and proposes the neutrophil-to-lymphocyte ratio as a cost-effective disease monitoring biomarker. Keywords: tuberculosis, white blood cell differential, lymphopenia, neutrophil-to-lymphocyte ratio, Gombe State.