title: Human cases of simultaneous echinococcosis and tuberculosis - significance and extent in China.
abstract: During analysis of retrospective community survey data, we identified two patients from Xiji County, south Ningxia Hui Autonomous Region with simultaneous echinococcosis and tuberculosis (TB), representing the first such reports for China. As the echinococcosis chronicity increased, the immune profile in both subjects changed from a Th1 to Th2 response, as shown by a TB skin test, originally positive, becoming negative. Such an elevated Th2 immune profile, with subsequent suppression of the Th1 immune response, is a common feature of chronic helminth infections. Given the difficulties in definitive diagnosis, and the potential increased susceptibility for TB infection in patients with advanced echinococcosis, we suggest that combined TB/echinococcosis surveys be undertaken in this area in the future. This would allow early diagnosis of both TB and echinococcosis cases with better prognosis for effective and sustainable treatment outcomes, ultimately reducing associated morbidity and mortality, and also the overall financial costs to the individual and the public health care system in this under developed part of China.
authors.affiliation: Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia. donM@qimr.edu.au.
authors.forename: Yu Rong
authors.initials: YR
authors.lastname: Yang
authors.forename: Darren J
authors.initials: DJ
authors.lastname: Gray
authors.forename: Magda K
authors.initials: MK
authors.lastname: Ellis
authors.forename: Shu Kun
authors.initials: SK
authors.lastname: Yang
authors.forename: Philip S
authors.initials: PS
authors.lastname: Craig
authors.forename: Donald P
authors.initials: DP
authors.lastname: McManus