Baluku Joseph Baruch, Nassozi Sylvia, Gyagenda Brian, Namanda Margret, Andia-Biraro Irene, Worodria William, Byakika-Kibwika Pauline
Mulago National Referral Hospital, Pulmonology Division, P.O. Box 7051 Kampala, Uganda.
Makerere University College of Health Sciences, Department of Internal Medicine, P.O. Box 7272 Kampala, Uganda.
J Trop Med. 2019 Jul 25;2019:3741294. doi: 10.1155/2019/3741294. eCollection 2019.
The prevalence of malaria and tuberculosis (TB) coinfection is not well established in countries that are highly burdened for both diseases. Malaria could impair TB containment and increase mortality of TB patients. The objective of this study was to determine the prevalence of malaria/TB coinfection among bacteriologically confirmed adult TB patients at a national TB treatment centre in Uganda. Using a cross-sectional study design we enrolled 363 bacteriologically confirmed adult TB patients, and data on demographics and medical history was collected. Blood samples were tested for malaria blood smear, rapid malaria diagnostic test (RDT), complete blood count, haematological film analysis, HIV serology, and CD4+ and CD8+ cell counts. Malaria was defined as either a positive blood smear or RDT. The study participants were mostly male (61.4%), with a median age of 31 (interquartile range, IQR: 25-39) years, and 35.8% were HIV positive. The prevalence of malaria was 2.2% (8/363) on the overall and 5% (3/58) among participants with rifampicin resistance. A triple infection of HIV, malaria, and rifampicin resistant TB was observed in 3 participants. The prevalence of malaria among TB patients is low, and further evaluation of the epidemiological, clinical, and immunological interaction of the two diseases is warranted.
在疟疾和结核病负担都很重的国家,疟疾与结核病合并感染的流行情况尚未完全明确。疟疾可能会削弱对结核病的控制,并增加结核病患者的死亡率。本研究的目的是确定乌干达一家国家级结核病治疗中心经细菌学确诊的成年结核病患者中疟疾/结核病合并感染的流行情况。我们采用横断面研究设计,纳入了363名经细菌学确诊的成年结核病患者,并收集了人口统计学和病史数据。对血样进行了疟原虫血涂片检测、疟疾快速诊断试验(RDT)、全血细胞计数、血液学涂片分析、HIV血清学检测以及CD4+和CD8+细胞计数检测。疟疾定义为血涂片或RDT检测呈阳性。研究参与者大多为男性(61.4%),中位年龄为31岁(四分位间距,IQR:25 - 39岁),35.8%的参与者HIV呈阳性。总体上疟疾的患病率为2.2%(8/363),在耐利福平的参与者中为5%(3/58)。在3名参与者中观察到HIV、疟疾和耐利福平结核病的三重感染。结核病患者中疟疾的患病率较低,有必要对这两种疾病的流行病学、临床和免疫相互作用进行进一步评估。