Gastrointestinal Parasitic Infestation in HIV Positive and Negative Patients Attending Clinics in a Tertiary Health Care Centre in Benue State, Nigeria.

L Utume,Te Ikpom,Ae Obaje,Ea Omudu

doi:10.46912/2i2.2019115

L Utume, Te Ikpom + Show 2 more

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https://doi.org/10.46912/2i2.2019115

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Abstract

Gastrointestinal parasitic infection is usually asymptomatic thus goes unnoticed and untreated for long periods of time, often resulting in other serious health complications. In HIV positive patients, the effects usually are more devastating owing to the fact that such patients are already immunocompromised. For this study, HIV positive patients were raised from the BSUTH STD/ART clinic records while HIV negative patients were recruited from other clinics by confirming their HIV status using Determine test strips to check for HIV antibodies; socio-demographic data was generated from questionnaires administered. Patients already placed on anti-helminths or anti-protozoan medicines were exempted from the study. Stool samples (n=550; 304 males 246 females) were examined for intestinal parasites using the standard parasitological procedures for direct wet mount and Formol-Ether Concentration methods. Gastrointestinal parasites were identified from 199 (36.2%) samples implying positive results for these infections: Giardia lamblia (3.8%), Entamoeba histolytica (8.9%), Ascaris lumbricoides (7.1%), Entamoeba coli (4.2%), Trichuris trichuria (3.3%), Strongyloides stercoralis (2.2%), Taenia sp. (1.8%), Trichomonas hominis (0.5%) and hookworms (2.9%). Out of this 199 only 55 (27.6%) were HIV positive; statistically there was a significant relationship between HIV status and the rate of parasitic infection (P<0.05). Personal hygiene practices, environmental sanitary conditions, overcrowding, limited access to clean potable water and poor drainage systems influenced gastrointestinal parasitic infection in both HIV positive and negative patients, HIV status may have increased intensity of gastrointestinal parasitic infection. The need for preventive awareness campaigns and mass chemoprophylaxis exercises cannot be overemphasized; government and private sector collaborations will have a wider coverage area and make a lot of impact.

Highlights

Gastrointestinal parasitic infestation is usually asymptomatic goes unnoticed and untreated for long periods of time, often resulting in other serious health complications
Intestinal problems in developing countries like Nigeria. It has been parasites can be categorized into protozoan and helminthic estimated to affect 3.5 billion people globally and 450 million infection -protozoa include Entamoeba, Giardia, Trichomonas, Cryptosporidium, Isospora and Balantidium species; and medically important helminths are nematodes, Cestodes and Trematodes.[2]. These intestinal parasites have been found to infest both individuals with Human Immunodeficiency Virus (HIV) and those without the infection immunocompromised (HIV positive) individuals with depleted immunity have an abnormally high susceptibility to infection with even minimally pathogenic organisms.3,4The high prevalence of gastrointestinal parasites in tropical countries including Nigeria is closely linked with poverty, poor environmental hygiene, improper waste disposal, inadequate water supply, sub-standard housing and lack of education.[5,6]
The general population survey in 2013 put Nigeria as the country with the third highest burden of HIV and AIDS in the world with an HIV prevalence rate of 3.4 %; this is slightly lower than the 3.6 % prevalence reported in 2007.7 At least 9 % of the 3.5 million people living in Benue State, Nigeria are believed to be living with HIV and 75 % of these individuals are rural dwellers.[8]

Summary

Introduction

Gastrointestinal parasitic infestation is usually asymptomatic goes unnoticed and untreated for long periods of time, often resulting in other serious health complications. Intestinal parasitic infection plays important roles in the progression of HIV infection, by further disturbing the immune system while it is already engaged in the fight against HIV.[9] Pathogenic intestinal parasitic infection such as Cryptosporidium sp., Cyclospora sp., Entamoeba histolytica and Giardia lamblia can last for months in immunocompromised (HIV) patients causing malabsorption of nutrients, gradual debilitation through dehydration, and metabolic abnormalities; they are responsible for severe diarrhoea episodes.[10] In developing countries, acute gastroenteritis caused by intestinal parasites is often a complex clinical presentation for medics and paramedics due to diagnostic and treatment regimen challenges It is the major cause of morbidity and mortality in millions of HIV patients annually.[11] Despite the use of combination antiretroviral therapy (cART), several HIV infected patients’ still present gastrointestinal parasitic infection and its attendant complications.[12] This study seeks to compare gastrointestinal prevalence rates amongst HIV positive and negative individuals in the study area with the findings of other researchers of similar works. The study will provide baseline information and empirical data for stakeholders involved in activities that seek to curb the prevalence of gastrointestinal parasitic infection among populations, especially HIV positive patients

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