Possible Antiplasmodic Effects of Antituberculosis Drugs on Tuberculosis Patients with Malaria in Owerri Imo State, Nigeria

Abstract

Malaria and Tuberculosis are diseases of poverty with oftentimes fatal outcome especially amongst the very poor. The possible chemotherapeutic effect of some Anti-tuberculosis drugs (Isoniazid, Rifampicine, Pyrazinamide and Enthambutol) on the malaria parasitemia of Tuberculosis (TB) patients undergoing treatment was assessed between April 2008 and September 2009. A total of 832 TB positive patients made up of 446 TB patients who had not commenced treatment (control) and 386 TB patients undergoing Chemotherapy at different regimented stages were involved in this study. These were periodically screened for malaria parasitemia and other blood parameters. The intensity of malaria parasitemia in positive blood smears were grouped into low (+), medium (++) and high (+++) based on average numbers of parasites per microscopic field (WHO, 1991). The ‘+’ indicates the relative parasite count. From the control group; 229 (51.3%) had malaria parasitemia of +, 69 (15.5%) and 57 (12.8%) had ++ and +++, respectively while 91 (20.4%) had no malaria. Of the 386 TB patients already undergoing therapy; 251 (65.0%) of the group at the initial phase of the study had no malaria parasite, while 135 (34.9%) had I+ parasitemia only. A total of 84 patients at the initial phase of treatment had no malaria parasite. As the study progressed, from a total of 151 TB patients at the continuation stage of 2 – 6 months, 79 (52.3%) had no malaria parasite, 67 (44.4%), 5 (3.31%) had + and ++, respectively. The 151 TB patients at the final stage of 7-8 months of treatment, had 37 patients (24.5%) with no malaria parasite, 48 (31.7%), 34 (22.5%) and 32 (21.2%) had +, ++ and +++ of malaria parasitemia, respectively. Age related prevalence of malaria parasite load showed that TB patients between the ages of 10 – 20 yrs. (3 no. (1.18%) had lower parasitaemia than TB patients in between the ages of 70 – 80yrs. (78 no. (30.7%). The sex related prevalence shows the male TB patients (53.9%) had more malaria parasitaemia than their female counterparts (46.1%). This study shows that TB drugs could have some antiplasmodic effect.