title: Intestinal parasite co-infection among pulmonary tuberculosis cases without human immunodeficiency virus infection in a rural county in China.
abstract: Epidemiologic studies of co-infection with tuberculosis (TB) and intestinal parasites in humans have not been extensively investigated in China. A cross-section study was conducted in a rural county of Henan Province, China. Pulmonary TB (PTB) case-patients receiving treatment for infection with Mycobacterium tuberculosis and healthy controls matched for geographic area, age, and sex were surveyed by using questionnaires. Fecal and blood specimens were collected for detection of intestinal parasites, routine blood examination, and infection with human immunodeficiency virus. The chi-square test was used for univariate analysis and multivariate logistic regression models were used to adjust for potential confounding factors. A total of 369 persons with PTB and 366 healthy controls were included; all participants were negative for human immunodeficiency virus. The overall prevalence of intestinal parasites in persons with PTB was 14.9%, including intestinal protozoa (7.9%) and helminthes (7.6%). The infection spectrum of intestinal parasites was Entamoeba spp. (1.4%), Blastocystis hominis (6.2%), Trichomonas hominis (0.3%), Clonorchis sinensis (0.3%), Ascaris lumbricoides (0.5%), Trichuris trichiura (2.2%), and hookworm (4.6%). The prevalence of intestinal parasites showed no significant difference between persons with PTB and healthy controls after adjusting for potential confounding factors. There was no factor that affected infection rates for intestinal parasites between the two groups. Infection with intestinal parasites of persons with PTB was associated with female sex (adjusted odds ratio [AOR] = 2.05, 95% confidence interval [CI] = 1.01-4.17), body mass index ≤ 19 (AOR = 3.02, 95% CI = 1.47-6.20), and anemia (AOR = 2.43, 95% CI = 1.17-5.03). Infection of healthy controls was only associated with an annual labor time in farmlands > 2 months (AOR = 4.50, 95% CI = 2.03-10.00). In addition, there was no significant trend between rates of infection with intestinal parasites and duration of receiving treatment for infection with M. tuberculosis in persons with PTB. The prevalence of intestinal parasites was not higher in persons with PTB, and there was no evidence that PTB increased susceptibility to intestinal parasites in this study. However, for patients with PTB, women and patients with comorbidities were more likely to be infected with intestinal parasites.
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, World Health Organization Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai, China; National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; Gushi County Center for Disease Control and Prevention, Henan Province, Gushi, China; Anhui Province Institute of Parasitic Disease Control, Hefei, China; Henan Province Center for Disease Control and Prevention, Zhengzhou, China.
authors.forename: Xin-Xu
authors.initials: XX
authors.lastname: Li
authors.forename: Jia-Xu
authors.initials: JX
authors.lastname: Chen
authors.forename: Li-Xia
authors.initials: LX
authors.lastname: Wang
authors.forename: Li-Guang
authors.initials: LG
authors.lastname: Tian
authors.forename: Yu-Ping
authors.initials: YP
authors.lastname: Zhang
authors.forename: Shuang-Pin
authors.initials: SP
authors.lastname: Dong
authors.forename: Xue-Guang
authors.initials: XG
authors.lastname: Hu
authors.forename: Jian
authors.initials: J
authors.lastname: Liu
authors.forename: Feng-Feng
authors.initials: FF
authors.lastname: Wang
authors.forename: Yue
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiao-Mei
authors.initials: XM
authors.lastname: Yin
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: He
authors.forename: Qiu-Ye
authors.initials: QY
authors.lastname: Yan
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Zhang
authors.forename: Bian-Li
authors.initials: BL
authors.lastname: Xu
authors.forename: Xiao-Nong
authors.initials: XN
authors.lastname: Zhou
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010272:Parasitic Diseases / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents