Department of Medical Laboratory Technology, Hossana College of Health Science, Hossana, Ethiopia.
Department of Medical Laboratory Technology, College of Health Sciences, Jimma University, Jimma, Ethiopia.
BMC Infect Dis. 2024 Aug 5;24(1):783. doi: 10.1186/s12879-024-09673-7.
Tuberculosis (TB) and intestinal helminths are diseases that pose a dual burden on public health in low-income countries. Previous studies have shown that helminths can affect the shedding of bacteria or the bacterial load in the sputum of active TB patients. However, there is limited information on bacterial load in TB patients with helminth infections.
This study aimed to compare bacterial load in helminths-infected and non-infected pulmonary tuberculosis patients at selected public health facilities in Jimma zone, Oromia, Ethiopia.
The study was conducted in Jimma Zone, Oromia, Ethiopia. A facility-based comparative cross-sectional study was employed from August 01, 2020, to January 2021. A total of 124 (55 intestinal helminths-infected and 69 non-infected) newly diagnosed smear-positive pulmonary tuberculosis (PTB) patients were included in the study. A convenience sampling technique was employed to recruit study participants, and a semi-structured questionnaire was used to collect data regarding socio-demographic characteristics and possible risk factors for intestinal helminths co-infection. Stool examination was performed using both wet mount and Kato Katz technique. Additionally, weight and height measurements, sputum, and blood samples were taken to determine body mass index, bacilli load, and diabetic mellitus, respectively. Data were entered into Epi-Data software version 3.1 and analyzed using Statistical Packages for Social Sciences (SPSS) Version 25. A statistically significant difference was defined as a P-value of less than 0.05.
Intestinal helminths reduced bacilli load 3 times more than intestinal helminths non-infected PTB (AOR = 3.44; 95% CI; 1.52, 7.79; P = 0.003) However, diabetes mellitus, HIV, drinking alcohol and cigarette smoking were not associated with bacilli load. The rate of co-infection TB with intestinal helminths was 44%. The three most prevalent parasites detected were Trichuris trichiura 29 (66%), hookworm 19 (43%), and Ascaris lumbricoides 11(25%)). Among co-infected patients about 36 (81.8%) had a single parasite infection, and 19 (43.2%) had multiple infections. A body mass index < 18.5 (AOR = 3.26; 95% CI; 1.25, 8.56;P = 0.016) and untrimmed fingernail status (AOR = 3.63; 95%CI;1.32,9.93;P = 0.012) were significantly associated with PTB- intestinal helminth -co-infection.
Helminth infection was associated with a lower bacilli load compared to helmenths non-infected PTB. The rate of co-infection TB with intestinal helminths was 44%. Trichuris trichiura was the most prevalent helminth. Untrimmed fingernail and a body mass index were associated with PTB-intestinal helminth co-infection.
结核病（TB）和肠道寄生虫是低收入国家公共卫生面临的双重负担。先前的研究表明，寄生虫可能会影响活动期结核病患者痰液中细菌的脱落或细菌载量。然而，关于有肠道寄生虫感染的结核病患者的细菌载量的信息有限。
本研究旨在比较吉姆马地区选定公共卫生机构中感染和未感染肠道寄生虫的肺结核患者的细菌载量，该地区位于埃塞俄比亚奥罗米亚州。
本研究在埃塞俄比亚奥罗米亚州的吉姆马地区进行。 2020 年 8 月 1 日至 2021 年 1 月期间，采用基于设施的对比性横断面研究。共有 124 名（55 名肠道寄生虫感染和 69 名未感染）新诊断的涂片阳性肺结核（PTB）患者纳入研究。采用便利抽样技术招募研究参与者，使用半结构式问卷收集有关社会人口统计学特征和肠道寄生虫合并感染可能危险因素的数据。采用湿片镜检和加藤厚涂片法进行粪便检查。此外，还进行了体重和身高测量、痰液和血液样本采集，以确定体重指数、细菌载量和糖尿病。数据输入 Epi-Data 软件 3.1 版，并使用社会科学统计软件包（SPSS）第 25 版进行分析。定义具有统计学意义的差异为 P 值小于 0.05。
肠道寄生虫使细菌载量减少了 3 倍，而感染肠道寄生虫的肺结核患者比未感染的肺结核患者（AOR=3.44；95%CI；1.52，7.79；P=0.003）。然而，糖尿病、HIV、饮酒和吸烟与细菌载量无关。肠道寄生虫合并肺结核感染的发生率为 44%。检测到的三种最常见的寄生虫分别是鞭虫 29 例（66%）、钩虫 19 例（43%）和蛔虫 11 例（25%）。在合并感染的患者中，约 36 例（81.8%）有单一寄生虫感染，19 例（43.2%）有多重感染。体重指数<18.5（AOR=3.26；95%CI；1.25，8.56；P=0.016）和未修剪的指甲状态（AOR=3.63；95%CI；1.32，9.93；P=0.012）与肺结核-肠道寄生虫合并感染显著相关。
与未感染肠道寄生虫的肺结核患者相比，寄生虫感染与较低的细菌载量相关。肠道寄生虫合并肺结核感染的发生率为 44%。鞭虫是最常见的寄生虫。未修剪的指甲和体重指数与肺结核-肠道寄生虫合并感染有关。
