Coinfection of malaria and tuberculosis among bacteriologically confirmed tuberculosis cases in Lagos, Nigeria

Abstract

Objective: To estimate the prevalence of malaria and tuberculosis (TB) coinfection among bacteriologically confirmed TB patients attending treatment clinics in Lagos, Nigeria, and to identify associated risks or protective factors.
Methods: A cross-sectional study was conducted in five TB treatment clinics in Lagos. All participants had bacteriologically confirmed TB. Malaria infection was diagnosed by examination of Giemsa-stained thick and thin blood smears under light microscopy. Data on demographics, medical history, and use of vector control tools (e.g., insecticide sprays, insecticide-treated bed nets, chemoprophylaxis) were collected using interviewer-administered pre-tested structured questionnaires.
Results: Out of 446 TB patients, 261 (58.5%) were male, with a mean age of 35.8±13.4 years; 84.1% were HIV-negative. Malaria/TB coinfection was observed in 2.2% (10/446), among newly diagnosed (anti-TB drug naïve), and mostly in patients aged 25–34 years. Only Plasmodium falciparum was detected. The use of indoor insecticide spray was significantly associated with reduced malaria/TB coinfection risk with users less likely to be infected than non-users (P=0.04; OR=0.26; 95%CI: 0.07–0.94).
Conclusions: Malaria coinfection was relatively uncommon in TB patients in Lagos, but when present it occurred in newly diagnosed, treatment-naïve individuals. Indoor insecticide spraying was protective against malaria in TB patients. These findings may suggest the potential value of integrating vector control strategies into TB care programs in malaria-endemic settings.

Keywords

Coinfection / Lagos / Malaria / Tuberculosis

Conflict of interest statement

The authors declare that there are no conflicts of interest.

Acknowledgements

We acknowledge the support received from the Lagos State Ministry of Health which approved the conduct of this study at the facilities from which samples were collected. Sincere thanks to the patients and parents/caregivers of the who participated in this study, and the research assistants and management team of the various TB treatment centers; Nigeria Institute of Medical Research, Yaba, Mainland Hospital, Yaba, Randle General Hospital Surulere, St Mathew Primary Health Care Centre (Catholic), Ajegunle, Amukoko in Ajeromi Ifelodu LGA, and Mushin General Hospital, Mushin.

Funding

The study received no extramural funding.

Data availability statement

The data supporting the findings of this study are available from the corresponding author upon request.

Authors’ contributions

All authors were responsible for the conception and design of the study as well as the writing of the manuscript. Oyibo W provided administrative support for the project. Igbasi U was in charge of the collection and assembly of data, in addition to the analysis and interpretation of the data.

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