Evaluation of Thyroid Hormones Changes and CD4+ T-cell Count during Menstrual Cycle in Pulmonary TB Infected Women in Nnewi, Nigeria
R. Ukibe Nkiruka *
Department of Medical Laboratory Science, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria.
N. Ukibe Solomon
Department of Prosthesis and Orthotics, School of Health Technology, Federal University of Technology, Owerri, Nigeria.
C. Onyenekwe Charles
Department of Medical Laboratory Science, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria.
E. Ahaneku Joseph
Department of Chemical Pathology, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria.
C. Chukwuanukwu Rebecca
Department of Medical Laboratory Science, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria.
Martin Ifeanyichukwu
Department of Medical Laboratory Science, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria.
N. Monago Ifeoma
Department of Medical Services, Federal Polytechnic, Oko, Anambra State, Nigeria.
A. Ilika Linus
Department of Community Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Tuberculosis remains a disease of major public health importance worldwide including Nigeria. Endocrine abnormalities have been reported among Tuberculosis patients with the thyroid inclusive.
Aims of Study: The present study was designed to evaluate the thyroid hormones changes and CD4+ T-cell count during menstrual cycle in women infected with Pulmonary Tuberculosis in Nnamdi Azikiwe University Teaching Hospital, Nnewi, south east Nigeria.
Materials and Methods: The study comprised 90 premenopausal females aged 15-45 years randomly recruited at Direct Observed Therapy (DOT) Clinic at NAUTH, Nnewi from 2013-2014. 30 participants were Symptomatic TB infected females who were not yet on drugs at the time of sample collection while 30 were Symptomatic TB infected females on Anti tuberculosis therapy. The remaining 30 were apparently healthy hospital staff with regular menstrual cycle. After due consent, a detailed medical history was obtained and routine investigations of pulmonary tuberculosis and confirmation using Ziehl Neelsen and sputum culture techniques for AFB and chest x-ray were done. Blood samples were collected at follicular and luteal phases of their menstrual cycle for analysis of Thyroid hormones (T3, T4 and TSH) using Enzyme Linked Immunosorbent Assay (ELISA) method. CD4 T-cell counts was determined using cyflow SL Green Cytometer.
Results: Result showed significantly lower T3 and CD4 T-cells with normal TSH values in Symptomatic TB compared with control females at both phases of menstrual cycle (P=.05 respectively). TSH value was significantly lowered in Symptomatic TB than Symptomatic TB on ATT while T3 and CD4 T-cell count were significantly higher in Symptomatic TB on ATT compared to Symptomatic TB at both phases of menstrual cycle (P=.05).
Conclusion: Euthyroid sick syndrome was observed among Symptomatic TB females which showed some level of improvements with administration of ATT. A new national strategic plan for TB control is advocated to include routine thyroid function check with special attention paid to the reproductive function.
Keywords: Thyroid hormones, CD4 T-cell count, menstrual cycle, pulmonary tuberculosis.