Research Highlights the Risk of Intestinal Worms Among Adult TB Patients

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It was a bittersweet moment when Mrs Khethiwe Bhengu graduated without her late husband with her Masters in Medical Microbiology - a dream he had supported from the onset of her studies.

Bhengu was left to raise their four children after the passing of her husband, Khumbulani. He looked after the children while she pursued her BTech in Biomedical Technology at Mangosuthu University of Technology (MUT). However, she drew strength from her fond memories and looks forward to registering for a PhD and obtaining a National Research Foundation rating. 

Bhengu, who works as a Control Industrial Technician in MUT’s Biomedical Science Department found that helminth infection (intestinal worms) alters the immune responses to tuberculosis (TB) in cases of helminth-coinfection, resulting in poor TB prognosis and treatment outcomes. 

Her study also raises awareness of the prevalence of helminths in adults and offers insights to policy-makers on the need to include screening for worms in TB treatment management programmes and indirectly HIV, because TB is a common opportunistic pathogen in HIV-infected patients. 

Bhengu said helminth infection is highly prevalent in adults aged 18 and older. ‘This is a public health concern because most deworming programmes in South Africa focus on children and school-going learners.’ She added: ‘Our research group will be presenting the findings to the community that participated in the study in order to raise awareness.’ 

Bhengu said that, while parasitology is becoming a neglected discipline, evidence shows that parasitic worms are highly prevalent in developing countries like South Africa. ‘TB has also persisted for years and has resulted in high fatality rates in HIV and TB-coinfected patients. The bidirectional relationship between TB and HIV has been extensively studied, but that of helminths and TB remains unclear. My supervisor, Professor Zilungile Mkhize-Kwitshana is also passionate about this field of research. She applied for funding that enabled me to embark on my research journey. 

‘We faced many challenges at the beginning of our study, one of which was COVID-19. We had just started recruiting participants in March 2020 when the pandemic hit and the country went on lockdown. This extended my study period because our study required interaction with clinic participants. Post-lockdown, when we resumed recruiting participants, very few patients attended the clinic for fear of contracting COVID-19. This caused further delays and challenges in recruiting the required sample size. 

‘UKZN is a well-equipped Institution, which made it possible for various analyses required for the study to be performed on-site,’ said Bhengu. ‘The other benefit is that critical equipment is connected to generators, meaning that laboratory work continued amidst load shedding because I was pressed for time to complete it. The facilities were adequate for multiple students in the Department to perform their experiments.’ 

Bhengu said she was on cloud nine after completing her master’s at the age of 41. ‘Having watched the Graduation ceremonies online, I always longed to be a part of the festivities.’ She added that her family are very proud of her. ‘I want to pursue my PhD so that I do not lose my momentum. I plan to continue researching and publishing in medical research journals, thus putting UKZN and MUT on the national and international map.’ 

In her spare time, Bhengu likes reading and watching TV, and she is learning beadwork. ‘My new hobby is exercising; it frees my mind and soul.’ 

Words and photograph: Lunga Memela