Prevalence and Risk Factors of Pulmonary Fungal Pathogens among Symptomatic Patients with or without Tuberculosis at Gombe, Nigeria

Pulmonary fungal infections are a significant etiology of morbidity among immunocompromised and immunosuppressed patients. This study aimed to determine the prevalence of fungal pathogens and associated risk factors among pulmonary tuberculosis (PTB) and non-PTB patients attending Federal Teaching Hospital, Gombe, Nigeria.

Three consecutive early morning sputum samples were collected from 43 PTB patients and 173 non-PTB persons and then examined for fungal pathogens using standard mycological stains, microscopy, and biochemical assays. All the participants were screened for HIV by the World Health Organization HIV testing algorithm and M. tuberculosis infection using GeneXpert ® nested PCR equipment. Samples with at least two significant fungal growths were considered positive.

Out of 216 sputa, 73.6% showed fungal growth in cultures. One hundred percent and 67% of PTB and non-PTB participants had positive sputa culture, respectively. In PTB patients, Candida albicans (25.6%) and Aspergillus fumigatus (20.9%), and in non-PTB individuals A. fumigatus (51.7%) and A. nigar (17.2%) were the most prevalent species. Age and residential areas were significantly associated with fungal infection in PTB and non-PTB subjects (p˂0.05). Cigarette smoking, prolonged antibiotic use, and having domestic pets were significant risk factors for developing pulmonary fungal infections in both groups (p˂0.05). None of the studied risk factors was significantly associated with pulmonary mycosis among TB patients (p˃0.05). However, prolonged use of antibiotics was a significant risk factor of pulmonary fungal infection among non-TB patients (p=0.009).

Our study showed that PTB was a predisposing factor for fungal infection, especially among individuals with low socioeconomic status.