Tuberculosis masquerading as 'constant malaria'.

Area of Science:

• Infectious Diseases
• Public Health
• Tropical Medicine

Background:

• Malaria and tuberculosis (TB) are significant public health concerns in endemic regions like Lagos, Nigeria.
• Co-infection and overlapping symptoms can complicate diagnosis and patient management.
• Understanding symptom presentation is vital for effective disease control.

Purpose of the Study:

• To investigate the relationship between symptoms suggestive of frequent malaria and tuberculosis infection in urban Lagos.
• To determine if early-stage tuberculosis can be misdiagnosed as 'constant malaria'.
• To assess the impact of antituberculosis therapy on malaria-like symptoms.

Main Methods:

• A cross-sectional study of 400 adults (200 males, 200 females) aged 20-60 years in urban Lagos.
• Data collection included self-reported symptoms (e.g., 'constant malaria'), sputum analysis for Acid-Fast Bacilli (AFB), chest X-rays, HIV testing, and Mantoux testing.
• Malaria parasite density was measured and compared between groups.

Main Results:

• 13% reported 'constant malaria' (>8 times/year), and all of these individuals were AFB smear positive.
• Malaria parasite density was significantly lower in those reporting 'constant malaria' (P=0.003).
• Frequent malaria complaints decreased after 6 months of antituberculosis therapy, and 1.5% of subjects had positive chest X-rays for pulmonary TB.

Conclusions:

• Early-stage tuberculosis can present with symptoms mimicking 'constant malaria' in endemic areas.
• Persistent malaria-like symptoms warrant thorough investigation for underlying tuberculosis.
• Prompt diagnosis and treatment of tuberculosis are essential, potentially alleviating malaria-like symptoms.