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. 2019 Oct 18;8(1):88.
doi: 10.1186/s40249-019-0600-2.

High helminthic co-infection in tuberculosis patients with undernutritional status in northeastern Ethiopia

Fikru Gashaw  1   2   3 , Samuel Bekele  4 , Yalemtsehay Mekonnen  5 , Girmay Medhin  4 , Gobena Ameni  4 , Berhanu Erko  4
Affiliations

High helminthic co-infection in tuberculosis patients with undernutritional status in northeastern Ethiopia

Fikru Gashaw et al. Infect Dis Poverty. .

Abstract

Background: Tuberculosis and parasitosis are the widely distributed diseases in Ethiopia with the leading cause of mortality and morbidity, respectively. There has been no information on the status of co-infections of tuberculosis and parasitosis in Oromia Zone of Amhara Region and South Wollo, Ethiopia. Hence, this study primarily focuses on determining the status of tuberculosis and parasitosis co-infections and associated factors.

Methods: The study was conducted in Oromia Special Zone of the Amhara Regional State and South Wollo Zone, northeastern Ethiopia from April 2015 to January 2017. Tuberculosis cases confirmed by health personnel at the health institutions were the source of the study sample. In a cross-sectional study 384 smear positive pulmonary and extra-pulmonary tuberculosis cases were recruited. Faecal specimens provided by the study participants were examined for parasitic co-infections using direct saline microscopic test, Kato-Katz and concentration techniques. Nutritional status was determined using body mass index and mid-upper arm circumferences. Data were analyzed using descriptive statistical methods and Pearson chi-square.

Results: Tuberculosis and parasitosis co-infection prevalence was 10.8%, and the proportion of intestinal helminths accounted for 9.7% while intestinal protozoa accounted for 1.9%. Cases with single parasitic infection was 89.3% among co-infected individuals. Co-infection of both disease was not significantly associated with gender and age (P > 0.05). The prevalence of undernutrition was 58.6% as determined using body mass index and 73.0% as determined using mid-upper arm circumference with no significant association with gender. Among all forms of tuberculosis cases (384) screened for the study, the bacterial positivity was relatively more common in males (55.5%) than females (44.5%). Tuberculosis lymphadenitis was found to be the most prevalent (85.9%) form of extra-pulmonary tuberculosis with cervical adenopathy (75.3%) being the commonly existing disease.

Conclusions: The rate of helminthic co-infection is predominantly high than that of intestinal protozoa. Single parasitic co-infection was more common than double or multiple co-infections. Both body mass index and mid-upper arm circumference anthropometric parameters revealed greater risk of undernutrition in tuberculosis patients. Thus, screening and prompt treatment of parasites in tuberculosis patients and a support of nutritional supplementation for malnourished tuberculosis patients should be further studied which might enhance the disease treatment and minimize the risk of its complexity.

Keywords: Co-infection; Northeastern Ethiopia; Parasitosis; Tuberculosis; Undernutrition.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Map of Ethiopia showing the catchment areas of the patients, April 2015 to January 2017
Fig. 2
Fig. 2
A flowchart outlining the general procedure of sample collection and TB-parasitic co-infections
Fig. 3
Fig. 3
Comparison of results of smear microscopy (FM & FNA) and GeneXpert with bacterial growth on LJ medium, Oromia Special Zone and South Wollo, northeastern Ethiopia, April 2015 to January 2017. FM: Fluorescent microscope. FNA: Fine-needle aspirates. MGS: Missed grading scale. EPTB: Extra-pulmonary tuberculosis. LNs: Lymphadenitis
See this image and copyright information in PMC

References

    1. Rao RN, Meena LS. Unique characteristic features of Mycobacterium tuberculosis in relation to immune system. Am J Immunol. 2011;7:1–8. doi: 10.3844/ajisp.2011.1.8. - DOI
    1. Brosch R, Gordon SV, Marmiesse M, Bordin P, Buchrieser C, Eiglmeier K, et al. A new evolutionary scenario for the Mycobacterium tuberculosis complex. Proc Natl Acad Sci U S A. 2002;99:3684–3689. doi: 10.1073/pnas.052548299. - DOI - PMC - PubMed
    1. WHO . Global tuberculosis report. Geneva: World health organization; 2018.
    1. Stepek G, Buttle D, Duce I, Behnke J. Human gastrointestinal nematode infections: are new control methods required? Int J Exp Pathol. 2006;87:325–341. doi: 10.1111/j.1365-2613.2006.00495.x. - DOI - PMC - PubMed
    1. Brooker S, Kabatereine NB, Smith JL, Mupfasoni D, Mwanje MT, Ndayishimiye O, et al. An updated atlas of human helminth infections: the example of East Africa. Int J Health Geogr. 2009;8:42. doi: 10.1186/1476-072X-8-42. - DOI - PMC - PubMed