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

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.