Intestinal Parasites Co-infection and Associated factors Among Active Pulmonary Tuberculosis Patients in Selected Health Centers, Addis Ababa, Ethiopia: A Case control study
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Date
2018-06
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Addis Ababa Universty
Abstract
Background: In co-endemic areas, co-infection rate of intestinal parasites(IP) and tuberculosis (TB) thought to be high. There are limited studies on the epidemiology of IP /TB co-infection in Ethiopia.The present study was done to generate evidence on the co-infection rate in urban setting.
Objective: To determine intestinal parasite co-infection rate and associated factors among active pulmonary TB patients in selected health centers of Kolfe Keraniyo Sub-city, Addis Ababa, Ethiopia.
Methods: Unmatched case-control study was conducted during the period between Jan 2017 and Jan 2018. Ninety one TB patients were enrolled in the case group, and 89 TB free individuals in control group. Socio-demographic characteristics and associated factors were collected using structured questionnaire. Sputum, stool and blood specimens were collected, processed and examined for TB, IP and hematological profiles, respectively. Data was entered and analyzed by SPSS Ver. 20. Descriptive statistics, Fisher's exact test, binary logistic regression, odds ratio, 95% confidence interval and independent-samples T test were used. A P-value of <0.05 was considered as statistically significant.
Results: The infection rate of intestinal parasites in TB patients and controls was 22% and 9%, respectively.There was statisically significant difference among cases and controls (COR=2.85, 95% CI=1.183-6.87). The most prevalent intestinal parasite was Gardia lamblia (8.8%), and followed equivalently by Ascaris lumbricoides, Haymenolopsis nana and Entamoeba histolytica/dispar (4.4%) in TB patients. Co-infection in TB patients was associated with residence (Fisher's exact test=7.260; p=0.046), BMI (AOR=6.715; 95% CI=1.655-27.251) and presence of dirty material in the finger (AOR=8.997; 95% CI=2.469-32.788). Anemia, leukocytosis and thrombocytosis were observed in 29.2%, 29.2% and 72% of TB patients respectively. Low value of hemoglobin was associated with intestinal parasitic infection (COR=8.333, 95% CI=2.454-28.297-6.8). Relatively higher mean eosinophil count was observed in helmenthis infected TB patients (x̅=334 cells/mm3) compared with non infected ones (x̅=262 cells/mm3) but the difference was not statistically significant (t=-1.011, p=0.327).
Conclusion: There was a statistical significant difference in the infection rate of intestinal parasites in TB patients compared to healthy household contacts. Variety of hematological changes was observed in TB patients; which might help for the diagnosis and prognosis of TB. Anemia was modified by intestinal parasitic infection. Routine stool examination before anti-TB treatment would be important.
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Keywords
Pulmonary tuberculosis, intestinal parasites, co-infection