Sex hormone Profile and its associated factors among adult Tuberculosis Patient at Gondar town, Northwest Ethiopia 2024: A Multi-Centered Comparative Cross-Sectional Study

Abstract

viii TB..................................................................................................................................Tuberculosis TGFβ.......................................................................................................Tumor Growth Factor Beta TNFα..................................................................................................Tumor Necrosis Factor Alpha UGRCSH....................................University of Gondar Referral Compressive Specialized Hospital UGTB..........................................................................................................Urogenital Tuberculosis WHO.......................................................................................................World Health Organization ix Abstract Background: Tuberculosis is caused by Mycobacterium tuberculosis, is the second leading cause of death from infectious disease worldwide. Tuberculosis impairs the gonadal axis and may associated with hypogonadism, which affects the quality of life in TB patients and as well influences on the severity of TB cases, though previous studies have reported conflicting results. Objective: This study aims to assess and compare sex hormone profiles among adult tuberculosis patients and matched controls and to identify its associated factors in Gondar town in 2024. Methods: A multi-centered institution-based comparative cross-sectional study was conducted from June 15 to August 20, 2024 among 300 eligible adult TB patients and matched controls in five health institutions in Gondar town. Participants were recruited using simple random sampling technique. Socio-demographic, anthropometric, biochemical, clinical and behavioral data were collected via structured questionnaire. Five milliliters of venous blood were used to determine hormone levels using Beckman coulter DXI 800 chemistry hormonal analyzer. The independent t-test, one-way ANOVA, Mann-Whitney U, Kruskal-Wallis H test, bivariable and multivariable statistical model was utilized for analysis and p value <0.05 with a 95% CI was considered as statistically significant. Result: Male TB patients showed significantly higher estradiol, LH and FSH (p<0.001), but lower testosterone (p<0.001). New TB patients had significantly lower progesterone level (p=0.004 vs TB case on Rx, p=0.02 vs controls). Female TB patients showed significantly lower testosterone, progesterone but higher FSH levels compared to controls (P<0.001). Estradiol and LH levels did not differ significantly. However, new TB patients had significantly higher median estradiol level (p<0.001). Treatment duration significantly affected testosterone, estradiol and progesterone levels. The overall prevalence of hypogonadism was 30.3% (95 % CI (25.2-35.9%), sex, dietary diversity and cortisol levels were significant determinants of hypogonadism in TB patients. Conclusion and recommendation: elevated mean level of estradiol, LH and FSH, but decreased testosterone in male and decreased median level of testosterone and progesterone with elevated FSH in females in TB patients. There was higher prevalence of hypogonadism, particularly in males. Early diagnose of these hormonal changes is crucial in TB patients.