In co-endemic areas, the co-infection rates of intestinal parasites(IP) and tuberculosis (TB) thought to be high. There are limited studies on the epidemiology of IP /TB co-infection in Ethiopia. This study was done to generate evidence on the co-infection rate in an urban setting. The objective of this study was to determine intestinal parasite co-infection rate and associated factors among active pulmonary TB patients in selected health centers of Kolfe Keraniyo Sub-city, Addis Ababa, Ethiopia. An unmatched case-control study was conducted during the period between Jan 2017 and Jan 2018. Ninety-one TB patients were enrolled in the case group, and 89 TB-free individuals in the control group. Socio-demographic characteristics and associated factors were collected using a structured questionnaire. Sputum, stool, and blood specimens were collected, processed, and examined for TB, IP, and hematological profiles, respectively. Data was entered and analyzed by SPSS Ver. 20. Descriptive statistics, Fisher's exact test, binary logistic regression, odds ratio, 95% confidence interval, and independent-samples T-test were used. A P-value of <0.05 was considered statistically significant.
Results of the study showed that: 1), The infection rate of intestinal parasites in TB patients and controls was 22% and 9%, respectively. 2), There was a statistically significant difference among cases and controls (COR=2.85, 95% CI=1.183-6.87). 3), The most prevalent intestinal parasite was Gardia lamblia (8.8%), and followed equivalently by Ascaris lumbricoides, Haymenolopsis nana, and Entamoeba histolytica/dispar (4.4%) in TB patients. 4), Co-infection in TB patients was associated with residence (Fisher's exact test=7.260; p=0.046), BMI (AOR=6.715; 95% CI=1.655-27.251) and presence of dirty material in the finger (AOR=8.997; 95% CI=2.469-32.788). 5), Anemia, leukocytosis, and thrombocytosis were observed in 29.2%, 29.2%, and 72% of TB patients respectively. 6), Low value of hemoglobin was associated with intestinal parasitic infection (COR=8.333, 95% CI=2.454-28.297-6.8). 7), a relatively higher mean eosinophil count was observed in helmenthis infected TB patients (x̅=334 cells/mm3) compared with non-infected ones (x̅=262 cells/mm3) but the difference was not statistically significant (t=-1.011, p=0.327). In conclusion, there was a statistically significant difference in the infection rate of intestinal parasites in TB patients compared to healthy household contacts. A variety of hematological changes was observed in TB patients; which might help for the diagnosis and prognosis of TB. Anemia was modified by intestinal parasitic infection. Routine stool examination before anti-TB treatment would be important.

Alemu, Ayinalem and Desta, Kassu, Intestinal Parasites Co-infection and Associated factors Among Active Pulmonary Tuberculosis Patients in Selected Health Centers, Addis Ababa, Ethiopia: A Case control study : URI: http://localhost:80/xmlui/handle/123456789/13490

This study was conducted in selected health centers of Kolfe Keraniyo Sub-city, Addis Ababa. Addis Ababa is the capital city of Ethiopia, which is located at the heart of the country, with an altitude ranging from 2,100 meters to 3,000meters above sea level. Addis Ababa lies 9°1′48″N latitude and 38°44′24″E longitude and the area covers 540 Sq.Km(39). The city had an estimated population of 3,156,077 in June 2013(40). Among the ten sub-cities in Addis Ababa, Kolfe Keraniyo Sub-city was selected using purposive sampling technique due to easier access to Health Centers and patient flow. The land area of the Kolfe Keraniyo sub-city is 6348.09 hectares (39). The sub-city is the largest populous sub-city with a population of 524,759 (40). In the sub-city, there are 11 health centers. Among these, 3 health centers were randomly selected and namely; Kolfe, Wereda 11 and Lomi meda health centers. These health centers provide outpatient services, including care and treatment for TB and HIV/AIDS patients and there is TB DOTs program.
The source and study population for this unmatched case-control study are patients visiting Kolfe, Wereda 11, and Lomi meda health centers for medical care and all patients visiting TB clinics in Kolfe, Wereda 11, and Lomi meda health centers respectively. Participants of the study include patients with bacteriologically confirmed active PTB and fulfill the inclusion criteria and Controls: Healthy household contacts to active PTB patients with no clinically and bacteriologically diagnosed TB.

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