Prevalence of Intestinal Parasitic Infections and Associated Factors among Presumptive Pulmonary Tuberculosis Patients at Debre Tabor Referral Hospital, South Gondar, Northwest Ethiopia: A Cross-Sectional Study

Abstract

Background. In developing countries, intestinal parasitic infections (IPIs) and tuberculosis (TB) coinfections have been perceived to be high. The geographic distributions of helminths and TB overlap substantially. Parasitic infections affect the outcome of TB by changing the cell-mediated immune response to a humoral response, while Mycobacterium infection favors the immune escape of helminths. There are limited studies on the epidemiology of intestinal parasites among presumptive pulmonary TB (PTB) patients in Ethiopia. Therefore, this study is aimed at determining the prevalence of intestinal parasitic infections and associated factors among patients with presumptive pulmonary tuberculosis at Debre Tabor Referral Hospital. Methods and Materials. A hospital-based cross-sectional study was conducted from March to June 2021. The sociodemographic data and associated factors were collected using a structured questionnaire, and stool samples were collected by convenient sampling technique and processed for the detection of intestinal parasites using a direct wet mount saline preparation and formal ether concentration technique. The data was coded, cleaned, and analyzed by SPSS version 23. Bivariate and multivariable analyses were conducted to determine an adjusted odds ratio (AOR). <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"><a:mi>p</a:mi></a:math> value &lt; 0.05 was considered statistically significant. Result. The overall prevalence of intestinal parasitosis was 25.6% (81/316); of these, 12.9% (41/316) were protozoan infections and 12.7% (40/316) were helminth infections. Multivariable logistic regression analysis showed that being older than 36 years (AOR: 4.35; 95% CI: 1.26, 13.91; <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"><c:mi>p</c:mi><c:mo>=</c:mo><c:mn>0.001</c:mn></c:math> ), rural residence (AOR: 3.46; 95% CI: 1.18, 9.97; <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"><e:mi>p</e:mi><e:mo>&lt;</e:mo><e:mn>0.001</e:mn></e:math> ), unable to read and write ( <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"><g:mtext>AOR</g:mtext><g:mo>=</g:mo><g:mn>2.62</g:mn></g:math> ; <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"><i:mn>95</i:mn><i:mi>%</i:mi><i:mtext>CI</i:mtext><i:mo>=</i:mo><i:mn>2.15</i:mn><i:mo>,</i:mo><i:mn>8.43</i:mn></i:math> ; <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"><k:mi>p</k:mi><k:mo>=</k:mo><k:mn>0.004</k:mn></k:math> ), and use of river water (AOR: 3.47; 95% CI: 1.62, 8.21; <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"><m:mi>p</m:mi><m:mo>&lt;</m:mo><m:mn>0.001</m:mn></m:math> ) were associated with intestinal parasitic infections. Conclusion. The present study showed that the prevalence of intestinal parasitosis among presumptive pulmonary tuberculosis patients was high in the study area. Age, residence, educational status, and source of water were significant factors in IPIs among presumptive TB patients. Moreover, our findings suggest a proper health education program for good personal hygiene habits, the coloration of water, avoiding open-field defecation, and also preventative measures to avoid the acquisition of IPIs in patients with TB. Presumptive tuberculosis patients should be screened and treated accordingly. Additionally, it needs further research and recommends more assessment for intestinal parasitic infection in PTB patients.