Polyparasitism in tuberculosis patients and apparently healthy individuals in Benue State, Nigeria

Abstract

Co-infection with intestinal parasites and tuberculosis infection is one of the leading causes of morbidity and mortality especially in resource poor countries in sub-Saharan Africa. A cross-sectional study in seven LGAs of Benue State was conducted to determine the prevalence of polyparasitism in tuberculosis patients and apparently healthy individuals. The TB patients were recruited from individuals already participating in the Directly Observed Short-course Treatment (DOTS) programme. These patients had varying degrees of tuberculosis severity and were categorized into scanty infection, light infection (1+), moderate infection (2+) and heavy infection (3+). Stool samples were examined using formal-ether concentration technique. A total of 661 tuberculosis patients were examined for intestinal parasites. 254 (38.4%) had at least one or more intestinal parasites. 153 (23.1%) of them harboured multiple parasites. However, of the 826 apparently healthy individuals, 333 (40.3%) were positive for at least one intestinal parasite. Out of these 333 positive individuals, 191 (23.1%) had multiple infections. Tarka Local Government Area had the highest prevalence (47%) of intestinal parasites which was significantly higher than Apa, the Local Government Area with the least prevalence of 17.7% parasitic infection, and this had no significant difference from the prevalence of multiple parasitism in the remaining six Local Government Areas sampled. On the whole; 1487 individuals were investigated, 557 (36.5%) had intestinal parasites and 364 (24.5%) had multiple parasitism. Eight different type of co-infections were encountered with the most frequent being hookworm and E. histolytica which was significantly higher than other types (p< 0.05) and was consistently higher in male tuberculosis patients. The occurrence of these co infections increased significantly (p< 0.05) with TB status of moderate (2+) to heavy infections (3+). The high prevalence of multiple intestinal parasites in tuberculosis patients poses a serious challenge to the current tuberculosis management strategy.

Keywords: polyparasitism, tuberculosis, Benue State, Nigeria