Hasanain Ahmad Farooq Alsayed, Zayed Ali Abdel-Azeem Hasan, Mahdy Reem Ezzat, Nafee Amany Mohamed Adawi, Attia Rasha Abdel-Monem Hassan, Mohamed Asmaa Omar
Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Department of Chest Diseases, Faculty of Medicine, Assiut University, Assiut, Egypt.
Int J Mycobacteriol. 2015 Dec;4(4):318-22. doi: 10.1016/j.ijmyco.2015.09.002. Epub 2015 Oct 1.
OBJECTIVE/BACKGROUND: The aim of this study is to determine the rate of hookworm infection among patients with pulmonary tuberculosis (TB) and to find out if there is a relation between hookworm infection and the therapeutic failure of pulmonary TB.
We carried out a prospective, hospital-based study. The study included 231 naïve patients with pulmonary TB, consecutively. Patients were evaluated at the 4th month of therapy for persistence of Mycobacterium tuberculosis infection. All patients had clinical evaluation, laboratory investigations (including sputum culture and stool microscopic examination), and imaging studies (abdominal ultrasonography and chest radiography).
The study population mean age was 42.7±13.9 years old with 26.8% of them 40 years old or more. Out of 231 patients, 133 (57.6%) were men. Therapeutic failure rate of pulmonary TB was 29.4%. Hookworm infection was diagnosed among 16.5% of patients and 27.7% had diabetes mellitus (DM). Using multivariate analysis, it was found that age of 40 years or more (odds ratio [OR] 8.4; 95% confidence interval [CI] 1.7-41.3; p=.009), hookworm infection (OR 7.6; 95% CI 1.2-49.9; p=.034), and DM (OR 5.9; 1.2-28; p=.027) were independently associated with therapeutic failure of pulmonary TB among the study population with pulmonary TB.
In conclusion, the rate of therapeutic failure of pulmonary TB is high. Besides older age and DM, hookworm infection can reduce the therapeutic response of pulmonary TB. Screening for and control of DM and hookworm infection among patients with pulmonary TB may improve their therapeutic response.
目的/背景：本研究旨在确定肺结核患者中钩虫感染率，并探究钩虫感染与肺结核治疗失败之间是否存在关联。
我们开展了一项基于医院的前瞻性研究。该研究连续纳入了231例初治肺结核患者。在治疗第4个月时对患者进行评估，以确定结核分枝杆菌感染是否持续存在。所有患者均接受了临床评估、实验室检查（包括痰培养和粪便显微镜检查）以及影像学检查（腹部超声和胸部X线摄影）。
研究人群的平均年龄为42.7±13.9岁，其中26.8%的患者年龄在40岁及以上。231例患者中，133例（57.6%）为男性。肺结核的治疗失败率为29.4%。16.5%的患者被诊断为钩虫感染，27.7%的患者患有糖尿病（DM）。通过多变量分析发现，40岁及以上（比值比[OR] 8.4；95%置信区间[CI] 1.7 - 41.3；p = 0.009）、钩虫感染（OR 7.6；95% CI 1.2 - 49.9；p = 0.034）和DM（OR 5.9；1.2 - 28；p = 0.027）在患有肺结核的研究人群中与肺结核治疗失败独立相关。
总之，肺结核的治疗失败率较高。除了年龄较大和患有DM外，钩虫感染会降低肺结核的治疗反应。对肺结核患者进行DM和钩虫感染的筛查与控制可能会改善他们的治疗反应。
