title: The impact of asymptomatic helminth co-infection in patients with newly diagnosed tuberculosis in north-west Ethiopia.
abstract: BACKGROUND
  Areas endemic of helminth infection, tuberculosis (TB) and HIV are to a large extent overlapping. The aim of this study was to assess the impact of asymptomatic helminth infection on the immunological response among TB patients with and without HIV, their house hold contacts and community controls.
  
  
  METHODS
  Consecutive smear positive TB patients (n = 112), their household contacts (n = 71) and community controls (n = 112) were recruited in Gondar town, Ethiopia. Stool microscopy, HIV serology, serum IgE level, eosinophil and CD4 counts were performed and tuberculosis patients were followed up for 3 months after initiation of anti-TB treatment.
  
  
  RESULTS
  Helminth co-infection rate was 29% in TB patients and 21% in both community control and household contacts (p = 0.3) where Ascaris lumbricoides was the most prevalent parasite. In TB patients the seroprevalence of HIV was 47% (53/112). Eosinophilia and elevated IgE level were significantly associated with asymptomatic helminth infection. During TB treatment, the worm infection rate of HIV+/TB patients declined from 31% (10/32) at week 0 to 9% (3/32) at week 2 of TB treatment, whereas HIV-/TB patients showed no change from baseline to week 2, 29% (13/45) vs. 22.2% (10/45). This trend was stable at week 8 and 12 as well.
  
  
  CONCLUSIONS
  One third of smear positive TB patients were infected with helminths. Eosinophilia and elevated IgE level correlated with asymptomatic worm infection, indicating an effect on host immunity. The rate of worm infection declined during TB treatment in HIV+/TB co-infected patients whereas no decline was seen in HIV-/TB group.
authors.affiliation: Department of Immunology and Molecular Biology, University of Gondar, Gondar, Ethiopia. ebbaabate@yahoo.com
authors.forename: Ebba
authors.initials: E
authors.lastname: Abate
authors.forename: Meseret
authors.initials: M
authors.lastname: Belayneh
authors.forename: Aschalew
authors.initials: A
authors.lastname: Gelaw
authors.forename: Jonna
authors.initials: J
authors.lastname: Idh
authors.forename: Assefa
authors.initials: A
authors.lastname: Getachew
authors.forename: Shitaye
authors.initials: S
authors.lastname: Alemu
authors.forename: Ermias
authors.initials: E
authors.lastname: Diro
authors.forename: Nigussu
authors.initials: N
authors.lastname: Fikre
authors.forename: Sven
authors.initials: S
authors.lastname: Britton
authors.forename: Daniel
authors.initials: D
authors.lastname: Elias
authors.forename: Abraham
authors.initials: A
authors.lastname: Aseffa
authors.forename: Olle
authors.initials: O
authors.lastname: Stendahl
authors.forename: Thomas
authors.initials: T
authors.lastname: Schön
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D015704:CD4 Antigens / Q000378:metabolism; D060085:Coinfection; D003140:Communicable Disease Control; D015897:Comorbidity; D005002:Ethiopia; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D006373:Helminthiasis / Q000150:complications* / Q000453:epidemiology*; D006376:Helminths; D006801:Humans; D007073:Immunoglobulin E / Q000378:metabolism; D055552:Infectious Disease Medicine / Q000379:methods; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014376:Tuberculosis / Q000150:complications* / Q000453:epidemiology*
chemical_list: D015704:CD4 Antigens; D007073:Immunoglobulin E