Lucia Sincu Gunawan, Expedito José Oliveira Livrança, Emma Ismawatie

Correlation Between Leukocyte Count and Erythrocyte Sedimentation Rate in Pulmonary Tuberculosis Patients at Suai Referral Hospital, Timor Leste

Introduction

Correlation between leukocyte count and erythrocyte sedimentation rate in pulmonary tuberculosis patients at suai referral hospital, timor leste. Investigate correlation between leukocyte count and erythrocyte sedimentation rate (ESR) in pulmonary TB patients at Suai Referral Hospital, Timor-Leste. No significant correlation found.

Abstract

Background: Human Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. TB causes serious health problems for about 10 million people each year and is one of the most common causes of death worldwide. The incidence of TB in Indonesia is 354 per 100,000 population, while in Timor-Leste the incidence has stagnated at 498 per 100,000 population. An active TB process may be indicated by an increase in leukocytes and LEDs, whereas an improvement is shown by a decrease in LEDs and normal lecocyte counts. Objectives: This study aimed to determine the correlation between leukocyte count and erythrocyte sedimentation rate (ESR) in pulmonary TB patients at Suai Referral Hospital, Timor-Leste. Materials and Methods: This was an observational analytic study with a cross-sectional approach, conducted from April to June 2023, using medical laboratory records. The study population consisted of pulmonary TB patients who underwent laboratory testing, with a total sampling of 50 patients. Data on leukocyte counts measured using an automated Hematology Analyzer and ESR determined by the Westergren method were tested for normality using the Shapiro-Wilk test, followed by Spearman’s rank correlation test. Results: The mean leukocyte count was 11.15 ± 5.24 /mm³ and the mean ESR was 63.30 ± 35.71 mm/hour. The correlation test between leukocyte count and ESR showed r = 0.124 (p = 0.392), indicating no significant correlation. Conclusions: There is no significant correlation between leukocyte count and ESR in pulmonary TB patients at Suai Referral Hospital, Timor-Leste.

Review

This study addresses a clinically relevant question regarding the utility of routine laboratory markers in monitoring pulmonary tuberculosis (TB) patients in Timor-Leste, a region with a high TB burden. The authors aimed to investigate the correlation between leukocyte count and erythrocyte sedimentation rate (ESR) in pulmonary TB patients at Suai Referral Hospital. Using a cross-sectional design and analyzing medical laboratory records from 50 patients, the study concluded that there is no significant correlation between these two widely used inflammatory markers in this specific patient population. The topic is pertinent given the global health significance of TB and the continuous need for simple, cost-effective monitoring tools, particularly in resource-limited settings. The methodological approach adopted was an observational analytic cross-sectional study, which is appropriate for exploring correlations between variables at a single point in time. The use of total sampling for 50 patients, while practical, could be a limitation in terms of generalizability, although the abstract does not provide information on the total eligible population from which these 50 were drawn. The reliance on established methods for laboratory measurements (automated Hematology Analyzer for leukocytes and Westergren method for ESR) is a strength, ensuring standardized data collection. The choice of Spearman’s rank correlation test, following a normality test, indicates an appropriate statistical approach for non-parametric data. However, the abstract lacks details on patient characteristics beyond the disease itself, such as age, sex, disease severity, or treatment status, which could influence these markers and potentially confound the analysis. Furthermore, the cross-sectional design inherently limits the ability to infer temporal relationships or changes over time, which is particularly relevant for markers often used for monitoring disease activity. The finding of no significant correlation between leukocyte count and ESR (r = 0.124, p = 0.392) is noteworthy. While both are general inflammatory markers often elevated in active TB, their lack of significant correlation suggests they may reflect different aspects of the inflammatory response or be influenced by distinct factors in this specific context. The high mean ESR (63.30 mm/hour) and moderately elevated mean leukocyte count (11.15 /mm³) in the study population indeed confirm an ongoing inflammatory process, yet their independent variability implies that one cannot reliably predict the other. This conclusion, therefore, challenges a potential assumption about their co-linearity in TB monitoring and implies that relying on one marker to infer the status of the other might be misleading. Future research could explore multivariate analyses to identify other factors influencing these markers, investigate these correlations longitudinally during treatment, or compare these findings with other populations to understand regional differences. Further details on patient demographics and clinical staging would also enrich the interpretation of these findings and help contextualize the observed lack of correlation.

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