Intestinal Parasite Co-infection among Pulmonary Tuberculosis Cases without Human Immunodeficiency Virus Infection in a Rural County in China

Abstract

Abstract. Epidemiologic studies of co-infection with tuberculosis (TB) and intestinal parasites in humans have not been extensively investigated in China. A cross-section study was conducted in a rural county of Henan Province, China. Pulmonary TB (PTB) case-patients receiving treatment for infection with Mycobacterium tuberculosis and healthy controls matched for geographic area, age, and sex were surveyed by using questionnaires. Fecal and blood specimens were collected for detection of intestinal parasites, routine blood examination, and infection with human immunodeficiency virus. The chi-square test was used for univariate analysis and multivariate logistic regression models were used to adjust for potential confounding factors. A total of 369 persons with PTB and 366 healthy controls were included; all participants were negative for human immunodeficiency virus. The overall prevalence of intestinal parasites in persons with PTB was 14.9%, including intestinal protozoa (7.9%) and helminthes (7.6%). The infection spectrum of intestinal parasites was Entamoeba spp. (1.4%), Blastocystis hominis (6.2%), Trichomonas hominis (0.3%), Clonorchis sinensis (0.3%), Ascaris lumbricoides (0.5%), Trichuris trichiura (2.2%), and hookworm (4.6%). The prevalence of intestinal parasites showed no significant difference between persons with PTB and healthy controls after adjusting for potential confounding factors. There was no factor that affected infection rates for intestinal parasites between the two groups. Infection with intestinal parasites of persons with PTB was associated with female sex (adjusted odds ratio [AOR] = 2.05, 95% confidence interval [CI] = 1.01-4.17), body mass index 19 (AOR = 3.02, 95% CI = 1.47-6.20), and anemia (AOR = 2.43, 95% CI = 1.17-5.03). Infection of healthy controls was only associated with an annual labor time in farmlands 2 months (AOR = 4.50, 95% CI = 2.03-10.00). In addition, there was no significant trend between rates of infection with intestinal parasites and duration of receiving treatment for infection with M. tuberculosis in persons with PTB. The prevalence of intestinal parasites was not higher in persons with PTB, and there was no evidence that PTB increased susceptibility to intestinal parasites in this study. However, for patients with PTB, women and patients with comorbidities were more likely to be infected with intestinal parasites.

Intestinal helminth co-infection and associated factors among tuberculosis patients in Arba Minch, Ethiopia

“…Patients with BMI < 18.5 were 3.511 (95% CI = 1.646–7.489) times at higher risk of acquiring helminth co-infection. Findings from China go in line with our results [11, 23]. This is expected as helminths cause under-nutrition [27, 28].…”

“…In rural areas where majority of people walk bare foot, hook worms may be more prevalent than A. lumbricoides . Xin et al [23] and Alemayehu et al [13] reported walking bare foot is associated with helminth infection. May be because most respondents are urban residents, shoe wearing habit was not associated factor in the present study.…”

“…The findings can help to estimate to the general adolescent/adult population of the study area as TB patients are part of the population. Xin et al from China reported that females are 2.05 times (95% CI = 1.01–4.17) more likely to acquire intestinal parasite infections than males [23]. Females were also at higher risk according to findings in Kenya by Anderek et al [22].…”

Spectrum of Parasitic Infections in Patients with Diarrhea Attending a Tertiary Care Hospital in Western Rajasthan, India

“…was suffering from tuberculosis. Intestinal parasitic coinfection with tuberculosis without HIV infection has been studied in the past [32]. Studies also have shown that coccidian parasites infect the immunocompromised patients suffering from HIV [33,34].…”

Prevalence of Intestinal Parasitic Infections in Shush County, Southwest of Iran during 2014 - 2016

“…Intestinal parasitic infections in majority of the cases are asymptomatic; however, IPIs can cause a whole range of clinical symptoms such as watery or mucoid diarrhea, dehydration, vomiting and nausea, abdominal pains and fever, vitamin deficiencies, growth retardation in children, iron deficiency anemia as well as mental and physical health disorders (3,5). In addition, the chronic IPIs are related with the risk of other infections, such as malaria, tuberculosis and viral infections (6,7), especially in immunocompromised individuals (8).…”