Intestinal Protozoans among HIV Patients in a Rural Setting, Southern Nigeria

Abstract

Opportunistic parasitic protozoan infections in HIV infected patients remain a worldwide public health concern. A cross sectional study on HIV patients was carried out in some parts of Imo State with a view of assessing the prevalence of intestinal protozoan parasites. Stool samples were collected and analysed applying standard techniques. Overall, four species of protozoan parasites were isolated namely, C.parvum, E.histolytica, G.lamblia and Ent. coli. Total prevalence is highest (52.2%) amongst the age group of ≤27 years, followed by 45-48years(27.8%) while the least prevalence(11.8%) is recorded for the age group of 49 years and above. More female (26.3%) were infected than male (25.4%). Significant association between age and protozoan prevalencewas noted(p-value=0.007; X2=32.998a, df=16). Further analysis selecting Cramer’s V which is the measure of association based on chi-square shows a weak dependence between age and parasite prevalence (Cramer’s V-value = 0.286). Pearson correlation shows a positive, weak (R=0.170; sig.=0.089c) relationship between age and protozoan parasite prevalence. Test of association between gender and intestinal protozoan parasites shows a non-significant association(p=0.280;X2=5.069a), weak dependence(Cramer’s V-value = 0.280) and a negative, weak relationship between gender and parasite prevalence(R=-0.042; sig=0.674c). Subjects with CD4count <200µ/ml recorded the highest(40.0%) prevalence of intestinal protozoan parasite while 200-349µ/ml recorded the least prevalence(4.0%).Significant association exists between CD4 count and parasite prevalence(x2=53.9a, df=12,p=0.001);then Cramer’s v test shows a medium-strong dependence. High prevalence (37.0%) of intestinal protozoan parasites is recorded for subjects not on HAART while low prevalence (12.8%) is recorded for those on HAART; with Significant association (x2=16.157a, df=4, p=0.003) and medium-strong dependence (Cramer’s v =0.40).The result of this study shows that intestinal parasites are of public health concern among immunocompromised individuals and calls for urgent attention of relevant stakeholders