It had been observed that tuberculosis (TB) subjects can be co-infected with Candida sp. which was previously assumed as normal flora of the oral cavity. Candida sp. might become an opportunistic pathogen in immune compromised individuals. Candida co-infection with Mycobacterium tuberculosis in TB patients might complicate underlying disease process in the lungs. Materials and Methods: A total of 400 sputum samples were collected from TB patients and examined using Ziehl-Neelsen staining technique and MDR/RIF Genexpert system for TB. Samples positive for Mycobacterium tuberculosis were cultured on Sabouraud Dextrose Agar with gentamicin and examined for the presence of budding yeast cells and pseudohyphae on Gram's stain. Candida sp. isolated from TB positive sputa were cultured on CHROMager Candida for identification to species level and subjected to antifungal susceptibility testing. Results: Out of 400 sputum samples examined for TB 93 (23.3%) were positive and 32 (34.4%) out of 93 TB positive cases were co-infected with Candida sp. Candida albicans was the most predominant species with a prevalence of 23 (67.6%), C. tropicals 4 (11.8%), C. krusei 4 (11.8%) and C. parapsilosis 3 (8.8%). One sample had dual infection. Female subjects had high prevalence (19.4%) than the male (15.7%). Age group 31 -40 years had both high prevalence of TB 32.3% and Candida 25.0%. Antifungal susceptibility testing showed that isolated Candida sp. were more susceptible to vericonazole and fluconazole compared to nystatin. Conclusions: Tuberculosis weakens the immune systems of infected persons especially when prophylactic administration proves abortive or there is non-adherence to treatment prescriptions. This may cause the development of multidrug resistance TB. Candida sp. may utilize these opportunities to establish alongside M. tuberculosis and worsen treatment and patient condition. For good treatment of TB, Candida co-infection should be screened concomitantly with TB in TB suspected individuals. How to cite this paper: Amala, S.E., Hanson, A. and Wokem G.N. (2020) Candida Co-Infection with Mycobacterium tuberculosis in Tuberculosis Patients and Antifungal Susceptibility of the Isolates.

There is an increase in the number of cases of antimicrobial resistance with a paucity of data from developing nations. This study is aimed at determining the antibiograms of uropathogens isolated from diabetics and non-diabetic subjects in three hospitals in Rivers State Port Harcourt, Nigeria. The Kirby-Bauer disc diffusion procedure was used to determine the antimicrobial susceptibility pattern of the uropathogens with the following antibiotics: vancomycin, cefotaxime, cefuroxime, imipenem, cefoxitin, ceftazidime, erythromycin, ciprofloxacin, tetracycline, amoxiclav and ofloxacin. The results show that S. aureus (20%), E. coli (9%), K. aerogenes (8%), and K. ascobata (7%) were the most prevalent bacterial isolates. Data showed the isolates were sensitive to imipenem (18.6%), ofloxacin (13.8%) and ceftazidime (12.3%). On the other hand, the antibiotics with the highest resistance were cefotaxime (9.5%), tetracycline (14.1%), erythromycin (18.4%), and vancomycin (21.1%). The diabetic subjects showed a significantly (P < 0.0001) lower prevalence of bacteria with MAR indices below 0.2 but a significantly (P = <0.0001) higher prevalence of bacteria showing MAR indices ≥0.2. In the analyses of MAR indices ≥0.2 bacterial isolates according to location. Abonnema had the highest percentage distribution, with higher number of diabetics (81%) to non-diabetics (19%), with P <0.0001. This was followed by Mgbundukwu, which had a higher number of diabetics (77%) to non-diabetics (23), with P < 0.0001, and then Eleme, with a higher number of diabetics (80%) to non-diabetics (20%), with P = <0.0001. This indicates a high level of antibiotic abuse hence resistance to antibiotics among diabetic patients.

Background: The COVID-19 pandemic began while improvement in malaria control and elimination had reached a peak. COVID-19 affected routine services particularly those for other killer infectious diseases including, HIV/AIDS and Malaria. This resulted in slowing progress in achieving control programs targets. Aim: The study was aimed at evaluating malaria and HIV coinfection among COVID-19 cohort in selected healthcare facilities in Rivers State of Nigeria. Methodology: The observational study showed a snapshot sampled only patients within the COVID-19 approved centers who consented to participate within the selected study area otherwise excluded. Simple random sampling technique was used to select 400 participants, giving subjects equal opportunity of participation. The majority of the data came from primary sources, but secondary sources were also used. Malaria testing was perform using microscopic method. Result outputs were presented on tables and charts. Results: The study showed high prevalence of malaria infection among COVID-19 patients -327 (81.8%) but low rate of HIV co-infection- 2 (0.5%). Conclusion: Much consideration should be channeled towards malaria endemicity and coinfection with COVID-19 unless it confers protective advantage as postulated by some studies however, a large scale and more in-depth study is suggested.

Background: The co-morbidity of malaria and COVID-19 is a growing public health concern since the outbreak of covid-19 especially in low and middle income countries due to poor healthcare facilities, system, personnel manpower and financial resources. It is generally known that age has a significant impact on malaria vulnerability, but with emerging concern on malaria and covid-19 co-infection, age based prevalence are among many studied characteristics of malaria prevalence in covid-19 patients especially in malaria endemic areas. Aim: The study was aimed at evaluating the impact of age in the prevalence of malaria and COVID-19 co-infection as well as some associated symptoms in Rivers State, Nigeria. Methodology: The study was a cross-sectional study conducted among 600 covid-19 patients admitted in Rivers State Covid-19 Treatment Centre, Eleme. Consenting subjects were randomly selected and were classified into three groups based on age; 0-25yrs, 26-50yrs and >50yrs. Blood samples were collected using venipuncture technique and blood was collected in EDTA bottles. Thick film was prepared was stained using Giemsa for malaria microscopy. All data generated were analyzed statistically using analysis of variance (ANOVA) and chi-square test with a P<0.05 considered significant. Result: Results showed that total malaria prevalence was 70.2 while on age group classifications, the prevalence was 100% in all age groups but healthy control group had less prevalence. This study has shown that prevalence of malaria among covid-19 subjects was significantly higher in all age groups (p<0.05). All symptoms were significantly associated with age at P<0.05; individuals >50years and 26 – 50years experienced more symptoms among COVID-19 patients and healthy volunteers respectively (P<0.05). Conclusion: This study has shown that malarial prevalence is absolutely higher among covid-19 subjects and the level of prevalence does not discriminate among age groups. However, more research work is needed to fully understand the relationship between malaria and COVID-19 co-infection due to the novel nature of the disease globally and their shared clinical symptoms.

Introduction: Some pulmonary tuberculosis subjects were some co-infected with Candida such as C. albicans, C. tropicalis, C. kruezi and C. paraspsilosis which were initially thought to be normal floras of the oral cavity. The percentage of tuberculosis patients co-infected with Candida is becoming a concern and might complicate the treatment of tuberculosis. Materials and Methods: A total of 400 sputum samples were collected and subjected to Ziehl-Neelsen staining technique and Genexpert system, Gram’s stain, Germ tube test and examination in KOH preparation were conducted. Culture on Sabouraud Dextrose Agar with gentamicin, and cultured on CHROMagar Candida and sugar fermentation were carried out for Candida. Results: Out of the 400 sputum samples examined 93(23.3%) had TB and 32(8.0%) were positive for Candida. By gender the prevalence of tuberculosis were females 51(22.4%), males 42(24.4%) while the prevalence of Candida were females 18(35.3%) and males 14(33.3%). The percentage occurrences of Candida sp. isolated were C. albicans which was the predominant species 10(21.5%), C. tropicals 5(5.4%), C. krusei 4(4.3%) and C. Parapsilosis 3(3.2%) respectively. Conclusion: Candida albicans remains the most predominant species of Candida in patients suffering from pulmonary tuberculosis and colonization by Candida sp should not be ignored. The presence of Candida sp. might contribute to in one way to the progression of the disease.