Abstract
IntroductionEnteric parasitic infections have been increasingly recognized as etiology of life-threatening chronic diarrhea in PLWHA in sub-Saharan Africa. This study investigated the prevalence and burden of intestinal parasitic infection among PLWHA in Abeokuta, southwest Nigeria.MethodsFreshly passed stool samples were collected from PLWHA. Detection of Cryptosporidium spp and Microsporidium spp was carried out with Kinyoun's stain and Weber's Chromotrope-based stain respectively. Investigation of other intestinal parasites was done using the direct saline preparation and formol-ether concentration methods. CD4+ T cell count was measured using Partec flow cytometry techniqueResultsA total of 231 (males: females 96:135; mean age 31.81±11.40 years) PLWHA were recruited into the study, among whom 84 (36.4%) were infected with at least one intestinal parasites. Fifty two (22.5%) individuals were positive for Cryptosporidium spp and a significant association between Cryptosporidium sppand diarrhea was observed (p=0.006). Seven (3.0%) were positive for Microsporidium spp. Helminths recovered included Ascaris lumbricoides (20.8%), hookworm (6.5%), Strongyloides stercoralis (4.3%), Trichuris trichiura (5.6%) and Taenia spp. (5.6%). Cryptosporidium spp, Microsporidium spp and S. stercoralis were significantly associated with CD4+ count ≥ 200 cells/mm3 (p<0.05). Cryptosporidium sppand A. lumbricoides were significantly observed among patients that are anti-retroviral therapy (ART) naive.ConclusionHigh prevalence of opportunistic parasitic infection was significantly correlated with diarrhea, low CD4+ count and ART naïve individuals in the study. These findings re-emphasize the need for early diagnosis of opportunistic parasites and appropriate intervention among PLWHA.
Highlights
IntroductionConclusion: High prevalence of opportunistic parasitic infection was significantly correlated with diarrhea, low CD4+ count and anti-retroviral therapy (ART) naïve individuals in the study
Enteric parasitic infections have been increasingly recognized as etiology of life-threatening chronic diarrhea in People living with Human Immunodeficiency Virus infection (HIV)/Acquired Immune Deficiency Syndrome (AIDS) (PLWHA) in subSaharan Africa
The resultant effect of such parasitic infections include chronic diarrhea, weight loss, and malnutrition, which has been associated with death among AIDS patients [4]
Summary
Conclusion: High prevalence of opportunistic parasitic infection was significantly correlated with diarrhea, low CD4+ count and ART naïve individuals in the study These findings re-emphasize the need for early diagnosis of opportunistic parasites and appropriate intervention among PLWHA. Cryptosporidium spp, Microsporidia and other coccidian parasites have emerged as significant causes of persistent diarrhea in People living with HIV/AIDS (PLWHA) [5]. These pathogens have been recognized as worldwide causes of diarrhea in all age groups, yet their most significant impact have been felt among individuals with weakened immune systems, especially PLWHA and organ transplant recipients [6]. The route of transmission is usually by ingestion of the spores, including evidence of spore inhalation or rectal transmission [12]
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