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Mark Hatherill

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Profile EDCTP Fellowship 1

Project Title

The risk of pulmonary tuberculosis associated with intestinal helminth infection among children at two tuberculosis vaccine trial sites in sub-Saharan Africa

EDCTP Project

TA.2009.40200.015

EDCTP Program

EDCTP1

EDCTP Project Call

Senior Fellowship (SF)

Project Objectives

Primary objectives: 1. To determine whether prevalent infection with intestinal helminths is associated with increased risk of pulmonary tuberculosis disease in children 2. To compare the risk of pulmonary tuberculosis disease associated with prevalent infection with intestinal helminths between the research site in Breede Valley, South Africa, and the research site in Siaya District, Kenya. Secondary specific aims: 1. To determine whether prevalent infection with intestinal helminths is associated with increased risk of LTBI in children 2. To determine whether maternal infection with intestinal helminths is associated with increased risk of LTBI in children

Study Design

Epidemiology

Host Organisation

Department Institution Country
University of Cape Town South Africa

Sites

Results & Outcomes

Results: UCT Site: Of the 209 participants enrolled, 177 participants had one TB Investigation and 32 participants had 2 admissions. Among the 177 children with one TB investigation, 19 cases of TB disease (10.7%) and 41 cases of TB Infection (23.1%) were observed. Only one child (0.8%) with helminth infection was observed. KEMRI Site: All of the 117 participants enrolled at the KEMRI site were 1st TB investigations, amongst whom only 5 children were diagnosed with TB disease (4.3%), less than half the rate at the UCT site. However, by contrast to the UCT site, 11 children (9.4%) had helminth Infection, a rate more than ten- fold greater. The findings of this study indicated that the childhood helminth co- Infection rate at the SATVI/UCT site has fallen dramatically from pre-study levels, perhaps due to public health Interventions such as mass deworming. Nevertheless, the incidence rate of childhood TB remains high. By contrast, the high prevalence of helminth Infection among children at the KEMRI/CDC site indicate that helminth co-infection should be considered as a potential confounder of TB vaccine trials and other studies at the site.