학술논문
Distinct clinical characteristics and helminth co-infections in adult tuberculosis patients from urban compared to rural Tanzania
Document Type
article
Author
George Sikalengo; Jerry Hella; Francis Mhimbira; Liliana K. Rutaihwa; Farida Bani; Robert Ndege; Mohamed Sasamalo; Lujeko Kamwela; Khadija Said; Grace Mhalu; Yeromin Mlacha; Christoph Hatz; Stefanie Knopp; Sébastien Gagneux; Klaus Reither; Jürg Utzinger; Marcel Tanner; Emilio Letang; Maja Weisser; Lukas Fenner
Source
Infectious Diseases of Poverty, Vol 7, Iss 1, Pp 1-12 (2018)
Subject
Language
English
ISSN
2049-9957
Abstract
Abstract Background Differences in rural and urban settings could account for distinct characteristics in the epidemiology of tuberculosis (TB). We comparatively studied epidemiological features of TB and helminth co-infections in adult patients from rural and urban settings of Tanzania. Methods Adult patients (≥ 18 years) with microbiologically confirmed pulmonary TB were consecutively enrolled into two cohorts in Dar es Salaam, with ~ 4.4 million inhabitants (urban), and Ifakara in the sparsely populated Kilombero District with ~ 400 000 inhabitants (rural). Clinical data were obtained at recruitment. Stool and urine samples were subjected to diagnose helminthiases using Kato-Katz, Baermann, urine filtration, and circulating cathodic antigen tests. Differences between groups were assessed by χ 2, Fisher’s exact, and Wilcoxon rank sum tests. Logistic regression models were used to determine associations. Results Between August 2015 and February 2017, 668 patients were enrolled, 460 (68.9%) at the urban and 208 (31.1%) at the rural site. Median patient age was 35 years (interquartile range [IQR]: 27–41.5 years), and 454 (68%) were males. Patients from the rural setting were older (median age 37 years vs. 34 years, P = 0.003), had a lower median body mass index (17.5 kg/m2 vs. 18.5 kg/m2, P