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Prevalence of Intestinal Parasites Co-infection and Associated Factors Among Pulmonary Tuberculosis Patients in Adama Town, East Shoa, Oromia, Ethiopia

Received: 26 December 2021     Accepted: 15 January 2022     Published: 26 January 2022
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Abstract

Tuberculosis and parasitic infections are co-endemic in many parts of the world. The treatments of many patients with tuberculosis are under the influence of Intestinal parasite infection that worsens the progression of this disease. Hence, adequate information on co-infection rate is needed to undertake the integrated prevention and control program. Therefore this study aimed to assess the prevalence of intestinal parasite co-infection and associated factors among pulmonary tuberculosis patients in Adama Town, East shoa, Oromia, Ethiopia. A facility based cross sectional study was conducted from November 2018 up to January 2019 using multi stage random sampling technique. Data on socio-demographic characteristics and potential risk factors for intestinal parasite co-infection was collected by standardized semi structured interviewer administered questionnaire. One gram stool samples for direct saline microscopy, formol-ether concentration technique and modified acid fast staining was collected and processed in accordance to the standard parasitological techniques and procedures at Adama Science and Technology University Higher Health Center Laboratory. Data entry was done by EPI info version 7, and analyzed using SPSS version 22.0. Pearson chi-square and multiple logistic regression models were used to identify associated factors. Overall co-infection rate of intestinal parasites was 75 (21.4%) (95% CI: 17.1-25.4). Protozoans’ account 40 (11.4%) and Helminthes were 35 (10.0%). The predominate isolates were Entamoeba histolytica 30 (40%) and Ascaris lumbricoides12 (16.0%) from protozoans and helminthes, respectively. Eating raw vegetables/ fruits without washing or peeling [AOR]: 5.311 (2.089-13.506), habit of not using soup [AOR]: 11.238 (3.134-40.296) and Body mass index<18.5 kg/m2 [AOR]: 15.337 (5.860-40.142) were significant determinants of intestinal parasite among pulmonary tuberculosis patient. In general overall co-infection rate of intestinal parasites in this study was high (21.4%). Therefore, integrating screening and mass deworming of parasite into existing tuberculosis program should be considered.

Published in Science Journal of Public Health (Volume 10, Issue 1)
DOI 10.11648/j.sjph.20221001.12
Page(s) 10-20
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Intestinal Parasite Co-infection, Pulmonary Tuberculosis, Adama, Ethiopia

References
[1] Z. L. Mkhize-Kwitshana, R. Tadokera, and M. H. Mabaso, “Helminthiasis: A Systematic Review of the Immune Interactions Present in Individuals Coinfected with HIV and/or Tuberculosis,” in Human Helminthiasis, InTech, 2017.
[2] M. Raviglione and G. Sulis, “Tuberculosis 2015: burden, challenges and strategy for control and elimination,” Infect. Dis. Rep., vol. 8, no. 2, Jun. 2016, doi: 10.4081/idr.2016.6570.
[3] R. Anuradha et al., “Anthelmintic Therapy Modifies the Systemic and Mycobacterial Antigen-Stimulated Cytokine Profile in Helminth-Latent Mycobacterium tuberculosis Coinfection,” Infect. Immun., vol. 85, no. 4, pp. e00973-16, Apr. 2017, doi: 10.1128/IAI.00973-16.
[4] N. S. Watts, M. M. Mizinduko, E. D. Barnett, L. F. White, and N. S. Hochberg, “Association between parasitic infections and tuberculin skin test results in refugees,” Travel Med. Infect. Dis., vol. 16, pp. 35–40, Mar. 2017, doi: 10.1016/j.tmaid.2017.03.007.
[5] E. Abate et al., “Effects of albendazole on the clinical outcome and immunological responses in helminth co-infected tuberculosis patients: a double blind randomised clinical trial,” Int. J. Parasitol., vol. 45, no. 2–3, pp. 133–140, Feb. 2015, doi: 10.1016/j.ijpara.2014.09.006.
[6] S. Anwar, “Impact of Helminth Infection on Antimycobacterial Immune Responses in UK Migrants,” London School of Hygiene & Tropical Medicine, 2017.
[7] G. G. Simon, “Impacts of neglected tropical disease on incidence and progression of HIV/AIDS, tuberculosis, and malaria: scientific links,” Int. J. Infect. Dis., vol. 42, pp. 54–57, Jan. 2016, doi: 10.1016/j.ijid.2015.11.006.
[8] Z. L. Mkhize-Kwitshana and M. L. H. Mabaso, “The neglected triple disease burden and interaction of helminths, HIV and tuberculosis: An opportunity for integrated action in South Africa,” S. Afr. Med. J., vol. 104, no. 4, p. 258, Feb. 2014, doi: 10.7196/SAMJ.7947.
[9] A. R. Board and S. Suzuki, “The interrelation between intestinal parasites and latent tuberculosis infections among newly resettled refugees in Texas,” Int. Health, p. ihv033, May 2015, doi: 10.1093/inthealth/ihv033.
[10] L. Neto et al., “Enteroparasitosis prevalence and parasitism influence in clinical outcomes of tuberculosis patients with or without HIV co-infection in a reference hospital in Rio de Janeiro (2000-2006),” Braz. J. Infect. Dis., vol. 13, no. 6, pp. 427–432, 2009.
[11] M. I. Sachiyo Nagi, “Relationship between Mycobacterium Tuberculosis and Hookworm Infections among School Children in Mbita, Kenya,” J. Trop. Dis., vol. 01, no. 03, 2013, doi: 10.4172/2329-891X.1000120.
[12] X.-X. Li et al., “Prevalence and risk factors of intestinal protozoan and helminth infections among pulmonary tuberculosis patients without HIV infection in a rural county in P. R. China,” Acta Trop., vol. 149, pp. 19–26, Sep. 2015, doi: 10.1016/j.actatropica.2015.05.001.
[13] E. M. Lipner et al., “Coincident filarial, intestinal helminth, and mycobacterial infection: helminths fail to influence tuberculin reactivity, but BCG influences hookworm prevalence,” Am. J. Trop. Med. Hyg., vol. 74, no. 5, pp. 841–847, 2006.
[14] D. Elias, G. Mengistu, H. Akuffo, and S. Britton, “Are intestinal helminths risk factors for developing active tuberculosis?: Intestinal helminths,” Trop. Med. Int. Health, vol. 11, no. 4, pp. 551–558, Apr. 2006, doi: 10.1111/j.1365-3156.2006.01578.x.
[15] E. Abate et al., “Asymptomatic Helminth Infection in Active Tuberculosis Is Associated with Increased Regulatory and Th-2 Responses and a Lower Sputum Smear Positivity,” PLoS Negl. Trop. Dis., vol. 9, no. 8, p. e0003994, Aug. 2015, doi: 10.1371/journal.pntd.0003994.
[16] T. Resende Co, C. S. Hirsch, Z. Toossi, R. Dietze, and R. Ribeiro-Rodrigues, “Intestinal helminth co-infection has a negative impact on both anti-Mycobacterium tuberculosis immunity and clinical response to tuberculosis therapy,” Clin. Exp. Immunol., vol. 0, no. 0, pp. 061127015327003-???, Nov. 2006, doi: 10.1111/j.1365-2249.2006.03247.x.
[17] J. A. Potian, W. Rafi, K. Bhatt, A. McBride, W. C. Gause, and P. Salgame, “Preexisting helminth infection induces inhibition of innate pulmonary anti-tuberculosis defense by engaging the IL-4 receptor pathway,” J. Exp. Med., vol. 208, no. 9, pp. 1863–1874, Aug. 2011, doi: 10.1084/jem.20091473.
[18] P. Salgame, G. S. Yap, and W. C. Gause, “Effect of helminth-induced immunity on infections with microbial pathogens,” Nat. Immunol., vol. 14, no. 11, pp. 1118–1126, Oct. 2013, doi: 10.1038/ni.2736.
[19] P. J. George et al., “Helminth Infections Coincident with Active Pulmonary Tuberculosis Inhibit Mono- and Multifunctional CD4+ and CD8+ T Cell Responses in a Process Dependent on IL-10,” PLoS Pathog., vol. 10, no. 9, p. e1004375, Sep. 2014, doi: 10.1371/journal.ppat.1004375.
[20] B. Amare, B. Moges, A. Mulu, S. Yifru, and A. Kassu, “Quadruple Burden of HIV/AIDS, Tuberculosis, Chronic Intestinal Parasitoses, and Multiple Micronutrient Deficiency in Ethiopia: A Summary of Available Findings,” BioMed Res. Int., vol. 2015, pp. 1–9, 2015, doi: 10.1155/2015/598605.
[21] D. Elias, H. Akuffo, and S. Britton, “Helminthes could influence the outcome of vaccines against TB in the tropics,” Parasite Immunol., vol. 28, no. 10, pp. 507–513, Oct. 2006, doi: 10.1111/j.1365-3024.2006.00854.x.
[22] S. Chatterjee et al., “Incidence of Active Pulmonary Tuberculosis in Patients with Coincident Filarial and/or Intestinal Helminth Infections Followed Longitudinally in South India,” PLoS ONE, vol. 9, no. 4, p. e94603, Apr. 2014, doi: 10.1371/journal.pone.0094603.
[23] P. Méndez-Samperio, “Immunological Mechanisms by Which Concomitant Helminth Infections Predispose to the Development of Human Tuberculosis,” Korean J. Parasitol., vol. 50, no. 4, pp. 281–286, Nov. 2012, doi: 10.3347/kjp.2012.50.4.281.
[24] M. Alemayehu, “Prevalence of Smear Positive Tuberculosis, Intestinal Parasites and Their Co-Infection among Tuberculosis Suspects in Gondar University Hospital and Gondar Poly Clinic, North West Ethiopia,” J. Microb. Biochem. Technol., vol. 06, no. 04, 2014, doi: 10.4172/1948-5948.1000140.
[25] G. Alemu and M. Mama, “Intestinal helminth co-infection and associated factors among tuberculosis patients in Arba Minch, Ethiopia,” BMC Infect. Dis., vol. 17, no. 1, Dec. 2017, doi: 10.1186/s12879-017-2195-1.
[26] L. Naing, T. Winn, and B. N. Rusli, “Practical Issues in Calculating the Sample Size for Prevalence Studies,” p. 6.
[27] D. Assafa, E. Kibru, S. Nagesh, S. Gebreselassie, F. Deribe, and J. Ali, “Medical parasitology,” Med. Parasitol. Lect. Notes Degree Diploma Programs Health Sci. Stud. Ethiop. Public Health Train. Initiat. Jimma Debub Gondar Univ., 2006.
[28] M. Martin, A. D. Blackwell, M. Gurven, and H. Kaplan, “Make New Friends and Keep the Old? Parasite Coinfection and Comorbidity in Homo sapiens,” in Primates, Pathogens, and Evolution, J. F. Brinkworth and K. Pechenkina, Eds. New York, NY: Springer New York, 2013, pp. 363–387. doi: 10.1007/978-1-4614-7181-3_12.
[29] M. Murguía-Romero et al., “The body mass index (BMI) as a public health tool to predict metabolic syndrome,” Open J. Prev. Med., vol. 02, no. 01, pp. 59–66, 2012, doi: 10.4236/ojpm.2012.21009.
[30] Y. Wang et al., “Intestinal Parasite Co-infection among Pulmonary Tuberculosis Cases without Human Immunodeficiency Virus Infection in a Rural County in China,” Am. J. Trop. Med. Hyg., vol. 90, no. 1, pp. 106–113, Jan. 2014, doi: 10.4269/ajtmh.13-0426.
[31] A. Kassu et al., “HIV and intestinal parasites in adult TB patients in a teaching hospital in Northwest Ethiopia,” Trop. Doct., vol. 37, no. 4, pp. 222–224, Oct. 2007, doi: 10.1258/004947507782333026.
[32] A. W. Hailu, Y. Y. Ayene, and M. K. Asefa, “The case control studies of HIV and Intestinal parasitic infections rate in active pulmonary tuberculosis patients in Woldia General Hospital and Health Center in North Wollo, Amhara Region, Ethiopia,” p. 17, 2016.
[33] A. Alemu, K. Desta, and A. Kebede, “Addis Ababa University College of Health Sciences School of Allied Health Sciences Department of Medical Laboratory Sciences,” p. 81, 2018.
[34] F. Mhimbira et al., “Prevalence and clinical relevance of helminth co-infections among tuberculosis patients in urban Tanzania,” PLoS Negl. Trop. Dis., vol. 11, no. 2, p. e0005342, Feb. 2017, doi: 10.1371/journal.pntd.0005342.
[35] G. Sikalengo et al., “comparatively studied epidemiological features of TB and helminth co-infections in adult patients from rural and urban settings of Tanzania.,” Infect. Dis. Poverty, vol. 7, no. 1, Dec. 2018, doi: 10.1186/s40249-018-0404-9.
[36] A. F. A. Hasanain, A. A.-A. H. Zayed, R. E. Mahdy, A. M. A. Nafee, R. A.-M. H. Attia, and A. O. Mohamed, “Hookworm infection among patients with pulmonary tuberculosis: Impact of co-infection on the therapeutic failure of pulmonary tuberculosis,” Int. J. Mycobacteriology, vol. 4, no. 4, pp. 318–322, Dec. 2015, doi: 10.1016/j.ijmyco.2015.09.002.
[37] N. A. Alyousefi, M. A. K. Mahdy, R. Mahmud, and Y. A. L. Lim, “Factors Associated with High Prevalence of Intestinal Protozoan Infections among Patients in Sana’a City, Yemen,” PLoS ONE, vol. 6, no. 7, p. e22044, Jul. 2011, doi: 10.1371/journal.pone.0022044.
[38] A. Alum, J. R. Rubino, and M. K. Ijaz, “The global war against intestinal parasites—should we use a holistic approach?,” Int. J. Infect. Dis., vol. 14, no. 9, pp. e732–e738, Sep. 2010, doi: 10.1016/j.ijid.2009.11.036.
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    Legese Lemma, Teklu Shiferraw, Godana Arero, Chala Diriba Feyissa, Lemlem Kebede. (2022). Prevalence of Intestinal Parasites Co-infection and Associated Factors Among Pulmonary Tuberculosis Patients in Adama Town, East Shoa, Oromia, Ethiopia. Science Journal of Public Health, 10(1), 10-20. https://doi.org/10.11648/j.sjph.20221001.12

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    Legese Lemma; Teklu Shiferraw; Godana Arero; Chala Diriba Feyissa; Lemlem Kebede. Prevalence of Intestinal Parasites Co-infection and Associated Factors Among Pulmonary Tuberculosis Patients in Adama Town, East Shoa, Oromia, Ethiopia. Sci. J. Public Health 2022, 10(1), 10-20. doi: 10.11648/j.sjph.20221001.12

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    AMA Style

    Legese Lemma, Teklu Shiferraw, Godana Arero, Chala Diriba Feyissa, Lemlem Kebede. Prevalence of Intestinal Parasites Co-infection and Associated Factors Among Pulmonary Tuberculosis Patients in Adama Town, East Shoa, Oromia, Ethiopia. Sci J Public Health. 2022;10(1):10-20. doi: 10.11648/j.sjph.20221001.12

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  • @article{10.11648/j.sjph.20221001.12,
      author = {Legese Lemma and Teklu Shiferraw and Godana Arero and Chala Diriba Feyissa and Lemlem Kebede},
      title = {Prevalence of Intestinal Parasites Co-infection and Associated Factors Among Pulmonary Tuberculosis Patients in Adama Town, East Shoa, Oromia, Ethiopia},
      journal = {Science Journal of Public Health},
      volume = {10},
      number = {1},
      pages = {10-20},
      doi = {10.11648/j.sjph.20221001.12},
      url = {https://doi.org/10.11648/j.sjph.20221001.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20221001.12},
      abstract = {Tuberculosis and parasitic infections are co-endemic in many parts of the world. The treatments of many patients with tuberculosis are under the influence of Intestinal parasite infection that worsens the progression of this disease. Hence, adequate information on co-infection rate is needed to undertake the integrated prevention and control program. Therefore this study aimed to assess the prevalence of intestinal parasite co-infection and associated factors among pulmonary tuberculosis patients in Adama Town, East shoa, Oromia, Ethiopia. A facility based cross sectional study was conducted from November 2018 up to January 2019 using multi stage random sampling technique. Data on socio-demographic characteristics and potential risk factors for intestinal parasite co-infection was collected by standardized semi structured interviewer administered questionnaire. One gram stool samples for direct saline microscopy, formol-ether concentration technique and modified acid fast staining was collected and processed in accordance to the standard parasitological techniques and procedures at Adama Science and Technology University Higher Health Center Laboratory. Data entry was done by EPI info version 7, and analyzed using SPSS version 22.0. Pearson chi-square and multiple logistic regression models were used to identify associated factors. Overall co-infection rate of intestinal parasites was 75 (21.4%) (95% CI: 17.1-25.4). Protozoans’ account 40 (11.4%) and Helminthes were 35 (10.0%). The predominate isolates were Entamoeba histolytica 30 (40%) and Ascaris lumbricoides12 (16.0%) from protozoans and helminthes, respectively. Eating raw vegetables/ fruits without washing or peeling [AOR]: 5.311 (2.089-13.506), habit of not using soup [AOR]: 11.238 (3.134-40.296) and Body mass index2 [AOR]: 15.337 (5.860-40.142) were significant determinants of intestinal parasite among pulmonary tuberculosis patient. In general overall co-infection rate of intestinal parasites in this study was high (21.4%). Therefore, integrating screening and mass deworming of parasite into existing tuberculosis program should be considered.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Prevalence of Intestinal Parasites Co-infection and Associated Factors Among Pulmonary Tuberculosis Patients in Adama Town, East Shoa, Oromia, Ethiopia
    AU  - Legese Lemma
    AU  - Teklu Shiferraw
    AU  - Godana Arero
    AU  - Chala Diriba Feyissa
    AU  - Lemlem Kebede
    Y1  - 2022/01/26
    PY  - 2022
    N1  - https://doi.org/10.11648/j.sjph.20221001.12
    DO  - 10.11648/j.sjph.20221001.12
    T2  - Science Journal of Public Health
    JF  - Science Journal of Public Health
    JO  - Science Journal of Public Health
    SP  - 10
    EP  - 20
    PB  - Science Publishing Group
    SN  - 2328-7950
    UR  - https://doi.org/10.11648/j.sjph.20221001.12
    AB  - Tuberculosis and parasitic infections are co-endemic in many parts of the world. The treatments of many patients with tuberculosis are under the influence of Intestinal parasite infection that worsens the progression of this disease. Hence, adequate information on co-infection rate is needed to undertake the integrated prevention and control program. Therefore this study aimed to assess the prevalence of intestinal parasite co-infection and associated factors among pulmonary tuberculosis patients in Adama Town, East shoa, Oromia, Ethiopia. A facility based cross sectional study was conducted from November 2018 up to January 2019 using multi stage random sampling technique. Data on socio-demographic characteristics and potential risk factors for intestinal parasite co-infection was collected by standardized semi structured interviewer administered questionnaire. One gram stool samples for direct saline microscopy, formol-ether concentration technique and modified acid fast staining was collected and processed in accordance to the standard parasitological techniques and procedures at Adama Science and Technology University Higher Health Center Laboratory. Data entry was done by EPI info version 7, and analyzed using SPSS version 22.0. Pearson chi-square and multiple logistic regression models were used to identify associated factors. Overall co-infection rate of intestinal parasites was 75 (21.4%) (95% CI: 17.1-25.4). Protozoans’ account 40 (11.4%) and Helminthes were 35 (10.0%). The predominate isolates were Entamoeba histolytica 30 (40%) and Ascaris lumbricoides12 (16.0%) from protozoans and helminthes, respectively. Eating raw vegetables/ fruits without washing or peeling [AOR]: 5.311 (2.089-13.506), habit of not using soup [AOR]: 11.238 (3.134-40.296) and Body mass index2 [AOR]: 15.337 (5.860-40.142) were significant determinants of intestinal parasite among pulmonary tuberculosis patient. In general overall co-infection rate of intestinal parasites in this study was high (21.4%). Therefore, integrating screening and mass deworming of parasite into existing tuberculosis program should be considered.
    VL  - 10
    IS  - 1
    ER  - 

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Author Information
  • Departement of Medical Laboratory, Adama Science and Technology University, Adama, Ethiopia

  • Department of Biomedical Science, Adama Hospital Medical College, Adama, Ethiopia

  • Departments of Public Health, Adama Hospital Medical College, Adama, Ethiopia

  • Department of Higher Health Center, Adama Science & Technology University, Adama, Ethiopia

  • Department of HIV/AIDS Prevention and Control Office, Adama Science and Technology University, Adama, Ethiopia

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