背景:结核病(TB)和肠道蠕虫是低收入国家对公共卫生造成双重负担的疾病。先前的研究表明,蠕虫可以影响活动性结核病患者痰中细菌的脱落或细菌负荷。然而,有蠕虫感染的结核病患者的细菌负荷信息有限.
目的:本研究旨在比较Jimma地区选定的公共卫生设施中蠕虫感染和未感染肺结核患者的细菌负荷,奥罗米亚,埃塞俄比亚。
方法:本研究在Jimma区进行,奥罗米亚,埃塞俄比亚。从2020年8月1日至2021年1月,进行了一项基于设施的比较横断面研究。该研究共纳入了124例(55例肠蠕虫感染和69例未感染)新诊断的涂片阳性肺结核(PTB)患者。采用了一种方便的抽样技术来招募研究参与者,半结构化问卷用于收集有关肠道蠕虫共感染的社会人口学特征和可能危险因素的数据.使用湿式安装和KatoKatz技术进行粪便检查。此外,体重和身高测量,痰,采集血样来确定体重指数,杆菌负荷,和糖尿病,分别。将数据输入Epi-Data软件版本3.1,并使用社会科学统计软件包(SPSS)版本25进行分析。统计学上的显著差异被定义为P值小于0.05。
结果:肠蠕虫比未感染PTB的肠蠕虫减少了3倍以上的细菌负荷(AOR=3.44;95%CI;1.52,7.79;P=0.003)但是,糖尿病,艾滋病毒,饮酒和吸烟与杆菌负荷无关.肠道蠕虫合并感染TB的比率为44%。检测到的三种最普遍的寄生虫是Trichuristrichiura29(66%),钩虫19(43%),和蛔虫11(25%))。在共感染的患者中,约有36例(81.8%)患有单一寄生虫感染,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;95CI;1.32,9.93;P=0.012)与PTB-肠蠕虫共感染显着相关。
结论:与未感染的PTB相比,蠕虫感染与较低的杆菌载量相关。肠道蠕虫合并感染TB的比率为44%。Trichuristrichiura是最普遍的蠕虫。未修剪的指甲和体重指数与PTB-肠道蠕虫共感染有关。
BACKGROUND: 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.
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.