Abstract
BackgroundIntestinal parasitic infections are known to cause gastroenteritis, leading to higher morbidity and mortality, particularly in people living with HIV/AIDS. This study aimed to determine the prevalence of Cryptosporidium and other intestinal parasitic infections among HIV patients receiving care at a hospital in Ethiopia where previous available baseline data helps assess if improved HIV-related care has reduced infection rates.MethodsA cross-sectional study was conducted at Hawassa University Hospital in southern Ethiopia from May, 2013 to March, 2014. A consecutive sample of 491 HIV- infected patients with diarrhea or a CD4 T cell count < 200 cells/μl were prospectively studied. A single stool sample was collected from each study participant and processed using direct, formol-ether concentration, and modified Ziehl-Neelsen techniques for the diagnosis of Cryptosporidium and other intestinal parasites. The study was approved by the Institutional Review Board of the College of Medicine and Health Sciences, Hawassa University. Physicians managed participants found to be infected with any pathogenic intestinal parasite.ResultsThe overall prevalence of intestinal parasitic infections among the study population was 35.8 %. The most prevalent parasites were Cryptosporidium (13.2 %), followed by Entamoeba histolytica/dispar (10.2 %), and Giardia lamblia (7.9 %). The rate of single and multiple infections were 25.5 and 10.3 %, respectively. Patients with a CD4 T cell count < 200 cells/μl had a similar rate of any intestinal parasitic infection or cryptosporidiosis compared to those with counts ≥ 200 cells/μl, but with some type of diarrhea.ConclusionThe study shows high prevalence of intestinal parasitic infections in the study population. However, the results in the current report are significantly lower compared to previous findings in the same hospital. The observed lower infection rate is encouraging and supports the need to strengthen and sustain the existing intervention measures in order to further reduce intestinal parasitic infections in people living with HIV/AIDS.
Highlights
Intestinal parasitic infections are known to cause gastroenteritis, leading to higher morbidity and mortality, in people living with HIV/AIDS
Cryptosporidium and other parasitic infections are known to cause gastroenteritis and malnutrition, which leads to significant morbidity and mortality, in people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/ AIDS)
We previously reported the high prevalence of protozoal and helminthic infections among HIV-infected people in southern Ethiopia where the infection rates for Cryptosporidium and S. stercoralis were shown to be up to 25 and 12.6 %, respectively [5, 12]
Summary
Intestinal parasitic infections are known to cause gastroenteritis, leading to higher morbidity and mortality, in people living with HIV/AIDS. Cryptosporidium and other parasitic infections are known to cause gastroenteritis and malnutrition, which leads to significant morbidity and mortality, in people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/ AIDS). Transmission of Cryptosporidium is mainly through the faecal-oral route, as well as through contaminated water and food, person-to-person spread and contact with infected animals [8] This parasite infection in immunodeficient patients may result in severe and chronic diarrhea, dehydration, wasting and death [9, 10]. Early initiation of antiretroviral therapy (ART) in HIV infected patients helps restore immunity and prevents acquisition and/or facilitates clearance of an established infection [11]
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