Environmental aspects related to tuberculosis and intestinal parasites in a low-income community of the Brazilian Amazon

Abstract

We carried out a cross-sectional study from January to December 2015 on 1,425 inhabitants from a floating population in the Brazilian Amazon (Murinin district, Pará State) to describe the population-based prevalence of tuberculosis (TB) from 2011 to 2014, recent TB contacts (rCts) latently infected with Mycobacterium tuberculosis (LTBI) , the coverage of the local health network, socio-environmental factors, and frequency of intestinal parasitic infection (IPI). We found that the sanitary structure was inadequate, with latrines being shared with other rooms within the same accommodation; well water was the main source of water, and 48% of families had low incomes. The average rate of TB was 105/100, 000 inhabitants per year; one third of TB patients had been household contacts of infected individuals in the past, and 23% of rCts were LTBI. More than half (65%) of 44% of the stools examined (representing 76% of the housing) had IPIs; the highest prevalence was of fecal-oral transmitted protozoa (40%, Giardia intestinalis ), followed by soil-transmitted helminths (23%). TB transmission may be related to insufficient disease control of rCts, frequent relocation, and underreporting. Education, adopting hygienic habits, improving sanitation, provision of a treated water supply and efficient sewage system, further comprehensive epidemiological surveillance of those who enter and leave the community and resources for basic treatment of IPIs are crucial in combating the transmission of these neglected diseases.

Strongyloides‐specific IgA, IgG and IgG immune complex profile in patients with pulmonary tuberculosis

“…The data in our study, despite the low number of positive cases in the faeces of the patients with TB (4%), are consistent with other authors, since the release of larvae can be compromised, especially due to the chronicity caused in these patients 25 …”

“…According to the WHO (2018), unsanitary conditions are directly associated with the high incidence of tuberculosis and intestinal infections, especially among low income populations 1 . However, the data on reports of parasitic infections are still underestimated 25 …”

“…Infection caused by S stercoralis is generally asymptomatic; however, in serious cases, cases of pulmonary oedema and respiratory insufficiency are common 26 . In these situations, during the cycle, the filaroid larvae (L3) of S stercoralis migrates to the lungs and can further worsen the symptoms caused by the presence of M tuberculosis in cases of coinfection 3,25 . Due to this fact, pulmonary symptoms (bronchospasm, cough, dyspnoea and expectoration of blood) may be caused by the parasites, reinforcing the importance of adequate diagnosis.…”

Beyond diversity loss and climate change: Impacts of Amazon deforestation on infectious diseases and public health

“…Urbanization, de-urbanization, poor sanitation, and deficient healthcare services are common phenomena in Amazonia (Silva 2006, Giatti 2007, Viana et al 2007, Carvalho-Costa et al 2009, Gomes et al 2009, Gorayeb et al 2009, Giatti & Cutolo 2012, Johansen & do Carmo 2012, Brierley et al 2014, Cardoso et al 2017. Taken together, these factors create the perfect storm for the occurrence of outbreaks and epidemics in the human population living or working in the Amazon region, especially in cities near forest areas and that have deforestation-associated activities.…”

Intestinal parasites and human immuno virus in Ethiopian tuberclosis patients: A Systematic review and meta-analysis.

“…The overlap of TB and parasitic disease morbidity presented with high and consistent figures all over the world (2)(3)(4)(5)(6). More than half of people with latent or active tuberculosis infections have intestinal parasitic infestation, which are common in high tuberculosis (TB) burden nations ( 7). In Africa, one-third of TB patients have intestinal parasite infection(IPIs) ( 8) that contribute for high rate of therapeutic failure of pulmonary TB ( 9).…”