High Schistosoma mansoni Co-Infection in Tuberculosis Patients with or without Human Immunodeficiency Virus: A Prospective Cohort Study.

BACKGROUND

People with Latent tuberculosis infection (LTBI) remain the reservoir of tuberculosis. One-third to 1/4 of the world's population is infected. Its reactivation is due to factors that disrupt the host's immune response. Recent findings showed that coinfection leads to a Th2/Th1 profile which results in an immune modulation that favors the escape of the Mycobacteria. may contribute to TB incidence in endemic regions. We aimed to investigate the co-infection rate and patient outcomes.

METHODS

A prospective cohort study was conducted between 2020-2022 at University Clinical Research Center (UCRC), including culture-confirmed active pulmonary TB patients and tested for in stools using Kato-Katz Technique. After descriptive analysis a logistic regression was performed to determine risk factors associated with TB and co-infection.

RESULTS

Data of 174 tuberculosis-confirmed patients, Kato-Katz tested were analyzed. Males represented 62.6%, mean age was 34.9 ± 13.8 years, 29.9% were smokers, alcohol consumption 13.8%, TB contact history 26.4%, HIV coinfection 11.5%, diabetes 6.3%, undernourished 55.7%. prevalence was 28.7%. The co-infection was associated with less lung cavitation [aOR = 0.24 [95% CI (0.06-0.85), p = 0.028], unfavorable treatment result [aOR = 2.95 (1.23-7.08), p = 0.015] and death [aOR = 3.43 (1.12-10.58), p = 0.032].

CONCLUSIONS

Despite Kato-Katz's low sensitivity, coinfection was found in one-third of the TB patients; 2.5-fold higher than that of HIV. The coinfection was associated with poor treatment results and death.