Immunocompromised patients with pulmonary tuberculosis; a susceptible group to intestinal parasites

Aim: To investigate the presence of intestinal parasites in tuberculosis patients who suffered from immunodeficiency disorders.

Background: Tuberculosis is an important infectious disease that is endemic in some regions of Iran. However, there is a coverage in the endemicity areas of this infection with intestinal parasites.

Methods: Stool samples were collected from 50 immunocompromised tuberculosis patients. Direct smear using the normal saline (0.85% NaCl solution) and Lugol's iodine staining were performed to detect trophozoite of parasites. Moreover, stool samples were concentrated using routine formalin-ether to detect protozoan cysts and helminth's ova/larvae. Specific staining techniques including Trichrome, Modified Ziehl-Neelsen and chromotrope 2R were employed to detect amoeba, Giardia spp., coccidian parasites and microsporidia.

Results: From 50 participants, 42 (84%) and 8 (16%) were male and female, respectively. The mean age + SD of patients was 47.88 + 10.88 years. Among the participated patients, HIV positive, cancer, organ transplant and receiving corticosteroids were seen in 13, 10, 15 and 12 subjects, respectively. The prevalence of Intestinal parasites was 34 %( 17/50). Blastocystis (18%; 9/50), and intestinal helminth (Enterobius vermicularis) (2%; 1/50) were the most prevalent and less prevalent parasites, respectively. Statistical significance difference was not seen between presence of intestinal parasites and type of immunodeficiency.

Conclusion: Our findings showed the high prevalence of intestinal parasites with majority of Blastocystis. Indeed, this study suggested that due to complicated immune conditions of TB patients with immunodeficiency disorders, this group of patients are at higher risk of infection by intestinal parasites.