Paragonimiasis in tuberculosis patients in Nagaland, India.
BACKGROUND
One of the infections that mimic tuberculosis (TB) is paragonimiasis (PRG), a foodborne parasitic disease caused by lung flukes of the genusParagonimus. In the northeastern states of India, TB and PRG are endemic; however, PRG is rarely included in the differential diagnosis of TB.


OBJECTIVE
To address limited evidence on the dual burden of TB and PRG in northeastern India, we aimed to document the prevalence of PRG among TB patients using sputum smear, stool examination for children <15 years and ELISA.


METHODS
A cross-sectional study of patients receiving TB treatment in the Médecins Sans Frontières (MSF)-supported TB programme in Mon district, in collaboration with the Regional Medical Research Centre (RMRC), Dibrugarh, Assam, between November 2012 and December 2013.


RESULTS
Of 96 patients screened between November 2012 and December 2013, three (3%) had pulmonary PRG and were successfully treated with praziquantel.


CONCLUSIONS
PRG should be considered in the TB diagnostic algorithms in PRG-TB dual burden areas. In case of TB-PRG co-infection, it is preferable to treat PRG first followed by anti-TB treatment a few days later.
Médecins Sans Frontières (MSF), Delhi, India; msfocb-delhi-epi@brussels.msf.org.
Mrinalini
M
Das
Médecins Sans Frontières (MSF), Mon, Nagaland, India.|Department of Biological Chemistry, The Alexander Silberman Institute of Life Science of HUJI, Jerusalem, Israel.
Katerina
K
Doleckova
Médecins Sans Frontières (MSF), Mon, Nagaland, India.
Rahul
R
Shenoy
Regional Medical Research Centre (RMRC), Dibrugarh, Assam, India.
Jagadish
J
Mahanta
Regional Medical Research Centre (RMRC), Dibrugarh, Assam, India.
Kanwar
K
Narain
Regional Medical Research Centre (RMRC), Dibrugarh, Assam, India.
K Rekha
KR
Devi
Médecins Sans Frontières (MSF), Mon, Nagaland, India.
Tongmeth
T
Konyak
Médecins Sans Frontières (MSF), Delhi, India.
Homa
H
Mansoor
Médecins Sans Frontières (MSF), Delhi, India.|Médecins Sans Frontières, Operational Research Unit, Luxembourg City, Luxembourg.
Petros
P
Isaakidis
lung fluke; northeast; operational research; praziquantel; zoonotic infection
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