Estimation of Tumor Necrosis Factor alpha and C-Reactive Protein Serum Levels in Sudanese Active Pulmonary Tuberculosis Patients Attending Aboanga Hospital, in Khartoum State, Sudan

Abstract

Mycobacterium tuberculosis (M. tuberculosis) is widely distributed pathogen especially in developing countries which cause primary and secondary pulmonary tuberculosis and if untreated, it causes extra pulmonary tuberculosis. This is analytical case control study was aimed to estimate the Tumor Necrosis Factor alpha (TNF-α) and C-reactive protein (CRP) serum levels in Sudanese active tuberculosis compared to healthy control group in Khartoum state during the period from March 2021 to March 2022. Blood specimen was collected from each subject, 44 of them were active pulmonary tuberculosis patients, and other 44 were apparently health control. TNF-α concentration was measured by Enzyme Linked Immunosorbent Assay (ELISA) in Institute of Endemic Disease and C-reactive protein concentration was measured by DIRUI Auto-Chemistry Analyzer CS-T180 in Al-Riada medical laboratory. The data was analyzed using SPSS Version 20. Active tuberculosis patients and apparently health control were enrolled in this study, their ages varied from 17-70 years, 44 subjects were active pulmonary tuberculosis, 33 of them were males and 11 were females with mean age (41±18.3 STD) years. The other 44 subjects were apparently healthy control 33 were males and 11 were females with mean age (41±18.3 STD) years. The mean level of TNF-α in active tuberculosis patient is higher (44.4 pg/ml), compared to control group (9.7 pg/ml) with statistical significant difference between case and control group (p-value 0.000). There was no statistical significant difference between TNF-α level and age, sex among cases subjects (p.value= 0.902, 0.564), respectively. The mean level of CRP in active tuberculosis patient is higher (53.9 mg /L) compared to control group (3.5 mg /L) with statistical significant difference between case and control group (p-value 0.000). There was no statistical significant difference between CRP level and age, sex among cases subjects (p.value = 0.406, 0.769), respectively. This study concluded that TNF-α concentration may be a useful diagnostic marker for active tuberculosis infection in combination with CRP level.