Serum procalcitonin in pulmonary tuberculosis

Area of Science:

• Infectious Diseases
• Biomarkers
• Clinical Medicine

Background:

• Pulmonary tuberculosis (PTB) remains a significant health challenge, particularly in West Africa.
• Understanding prognostic markers for PTB is crucial for patient management and outcomes.
• Procalcitonin (PCT) and C-reactive protein (CRP) are inflammatory markers with potential roles in infectious diseases.

Purpose of the Study:

• To assess the levels of procalcitonin (PCT) in West African out-patients diagnosed with pulmonary tuberculosis (PTB).
• To determine the prognostic value of PCT in predicting mortality risk in this cohort.
• To correlate PCT and CRP levels with disease severity.

Main Methods:

• A cohort of 218 West African PTB out-patients was studied, with clinical scoring and categorization into severity classes (SC I+II vs. SC III).
• Baseline levels of PCT and CRP were measured and compared to 50 healthy controls.
• Spearman's rank correlation and log-rank tests were used to analyze associations with TB score and survival, respectively.

Main Results:

• PCT and CRP levels were significantly higher in PTB patients than controls, and elevated in severe disease (SC III).
• Both PCT and CRP correlated positively with the clinical TB score.
• Increasing baseline PCT levels significantly predicted an increased risk of mortality (P = 0.01), unlike CRP (P = 0.887). HIV status did not affect these findings.

Conclusions:

• In West African PTB patients, PCT levels are generally low but increase with disease severity.
• Procalcitonin serves as a valuable prognostic marker for mortality risk in this population.
• PCT measurement can aid in risk stratification and management of PTB patients in resource-limited settings.