Hematological Phenotypes and Acute-Phase Kinetic Interactivity in Pulmonary versus Extrapulmonary Tuberculosis Across Native and Migrant Cohorts

Narjes El Osta; Aya muftah; Aisha Benkhalefa; Salma Zahmul; Shahed Abu hmaida; Najiyah Rasheed

doi:10.54361/ajmas.269710

Authors

Narjes El Osta Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Tripoli, Libya. https://orcid.org/0000-0001-5479-6954
Aya muftah Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Tripoli, Libya. https://orcid.org/0000-0001-6823-8777
Aisha Benkhalefa Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Tripoli, Libya https://orcid.org/0000-0001-6823-8777
Salma Zahmul Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Tripoli, Libya. https://orcid.org/0009-0004-4604-7282
Shahed Abu hmaida Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Tripoli, Tripoli, Libya. https://orcid.org/0009-0005-1810-016X
Najiyah Rasheed National Tuberculosis program, National Center for Disease Control, Tripoli, Libya. https://orcid.org/0009-0005-7744-0332

DOI:

https://doi.org/10.54361/ajmas.269710

Keywords:

Tuberculosis, Hematological Indices, Acute-phase kinetics, Citizenship status, Tripoli

Abstract

Characterizing host hematologic and inflammatory kinetics during active Mycobacterium tuberculosis infection across different anatomical pathways is crucial for improving clinical triage. However, a critical analytical gap remains regarding how native Libyan versus migrant status independently influences these systemic inflammatory networks in Tripoli. To address this, this paper profiles baseline cellular damage and isolates the independent effects of these administrative backgrounds within the urban healthcare sectors. Retrospective data from Abu-Setta Hospital and Taj Al-Seha Clinic were analyzed using 200 participants: 100 active TB cases (50 Libyans, 50 migrants) and 100 healthy controls (86 Libyans, 14 migrants) whose eligibility required complete blood counts, lymphocyte percentages, acute-phase markers (CRP, ESR), and definitive microbiological/radiological confirmation. Results demonstrated that active infection induces a classic phenotype of anemia of chronic disease, significantly suppressing hemoglobin levels across infected Libyans (10.29 ± 2.57 g/dL) and migrants (9.91 ± 2.39 g/dL) compared to their healthy national controls (12.48 ± 2.05 and 12.31 ± 1.47 g/dL, P < 0.001), alongside severe innate leukocytosis. Crucially, when stratified by citizenship, native Libyan patients exhibited markedly higher baseline leukocyte counts (12.18 ± 7.47 vs. 9.58 ± 4.14 × 10³/μL, P = 0.029) and profoundly elevated C-reactive protein concentrations (140.34 ± 98.80 mg/L) than their migrant counterparts (107.81 ± 54.17 mg/L, P = 0.040). Multivariable modeling confirmed host citizenship status acts as a standalone determinant of hepatic acute-phase reactivity (P = 0.040, partial P = 0.042), remaining uniform across both pulmonary and advanced extrapulmonary routes (P > 0.05). Overall, this paper presents a promising, cost-effective approach for accurately predicting mycobacterial severity and uncovering extended socio-behavioral diagnostic delays in native patients, highlighting the urgent need for decentralized screening in mobile communities to curb the 60.0% domestic relapse rate.