Opportunistic Intestinal Parasites Research Articles

Opportunistic and other intestinal parasites infections among HIVpositive patients in the era of combination antiretroviral therapy and preventive treatment in Ouagadougou, Burkina Faso

Opportunistic and other intestinal parasites infections among HIVpositive patients in the era of combination antiretroviral therapy and preventive treatment in Ouagadougou, Burkina Faso

Opportunistic and other intestinal parasites infections among HIV-positive patients in the era of combination antiretroviral therapy and preventive treatment in Ouagadougou, Burkina Faso

Background: One of the particularities of human immunodeficiency virus (HIV) infection in the tropics is its frequent association with parasitic diseases so frequent in this area. Aim: The aim of this study was to update the epidemiological and clinical profile of intestinal parasites among HIV-positive patients in the era of combination antiretroviral therapy (ART) and preventive treatment in Ouagadougou, Burkina Faso. Materials and Methods: A cross-sectional study was conducted in a single health care system, Yalgado Ouédraogo University hospital, between January 2013 and December 2014. A total of 131 HIV-infected patients were included in the study. Blood and Stool samples were collected for CD4 counts and for intestinal parasitic examination using direct, formol-ether concentration, a concentration method using sodium chloride solution, modified Ziehl-Neelsen and Weber modified trichrome. Odds ratio was calculated to estimate the risk attributable to different factors with confidence intervals. Chi-square (X2) or Fisher’s Exact Test statistical analysis was used to test level of significance at p<0.05 using SPSS 20.0.0. Results: A prevalence of 73.3% of intestinal parasites was recorded. Most of the parasitic infections were protozoa (97.9%) with few helminths (2.1%). Cryptosporidium spp. (29.2%), was the most commonly found parasite followed by Entamoeba coli (23.9%) and Isospora belli (21.9%). There were 76 cases (78.5%) of single infection and 20 cases (21.5%) of mixed infection. Paradoxically, patients who use preventive treatment were more infected with opportunistic parasites (p= 0.05, OR=2.16, 95% CI= 1.06-4.40). In multivariate analysis, patients with diarrhea (OR=4.04, 95% CI=1.94-8.41), and illiterate (OR=3.70, 95% CI=1.68-8.14) had higher risk of opportunistic parasites. The diarrheic patients were 0.29 times more likely to be infected with opportunistic parasites. Conclusion: Despite the advent of combination ART and preventive treatment of opportunistic infections, intestinal parasites remain very prevalent and associated with diarrhea among patients with HIV in Ouagadougou.

Intestinal parasitic infections and its association with undernutrition and CD4 T cell levels among HIV/AIDS patients on HAART in Butajira, Ethiopia

BackgroundIntestinal parasitic infections and HIV/AIDS have been the major public health problems and remain a vital cause of morbidity and mortality in developing countries. Both problems are linked in a vicious cycle. The magnitude of intestinal parasites was prevalent among people living with HIV/AIDS even in the HAART era. However, the pertinent risk factors associated with intestinal parasites among HIV/AIDS patients were not well investigated in Ethiopia particularly at Butajira town. Therefore, the aim of this study was to determine the prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients on HAART in Butajira, Ethiopia.MethodA cross-sectional study was conducted, and a total of 323 study subjects was involved in the study. A systematic random sampling technique was used to select each participant during data collection. Stool specimen was collected and processed using direct wet mount, formol-ether concentration technique, and modified Ziehl-Neelson staining techniques to identify both common and opportunistic intestinal parasites. Structured questionnaire was used to collect socio-demographic, environmental, clinical, and nutritional data. Both bivariate and multivariate logistic regression analyses were used to assess the association of various explanatory factors on intestinal parasites. P value ≤0.05 at 95% CI was considered statistically significant.ResultsThe overall prevalence of intestinal parasites was 35.9% (95% CI 31.0–40.9%). Protozoa’s (Entanmoeba histolytica/dispar trophozoite, E. histolytica/dispar cyst, Giardia lamblia trophozoite, and G. lamblia cyst), helminths (Tanea species, Ascaris lumbricoides, Strongyloid stercoralis, Hookworm species and H. nana), and opportunistic intestinal parasites (Cryptosporidium parvum, Isospora belli) were observed in 57 (17.1%), 46 (14.4%), and 28 (8.7%) study participants respectively. Multivariate logistic regression analysis revealed that the presence of animals (AOR 6. 14; 95% CI 3.13, 12.0); using river water (AOR 4.87; 95% CI 1.14, 20.7); undernutrition (AOR 2.59; 95% CI 1.36–4.95); and level of immunosuppression (AOR 4.02; 95% CI 1.78–9.05 and AOR 2.84; 95% CI 1.37–5.89) were significantly associated with intestinal parasites.ConclusionsThe prevalence of intestinal parasites found to be higher among HIV/AIDS patients receiving HAART at Butajira Hospital, southern Ethiopia. Presence of animals, using river water, lower CD4 T cell count, and undernutrition were significant factors affecting intestinal parasites. Therefore, consistent detection of intestinal parasites and deworming of patients should be performed as well as improving health education on personal hygiene, avoiding contact with pit or domestic animals, and using safe or treated water. Furthermore, improving nutritional support and household food access are recommended.

Prevalence of Intestinal Parasites and Associated Factors among AdultPre-ART and ART Patients in Goncha Siso Enesie Woreda, East Gojjam,Northwest Ethiopia, 2014

Background: The prevalence of opportunistic intestinal parasites is expected to be high among Human Immune Deficiency Virus infected populations in developing countries. For many years, intestinal infections caused by opportunistic organisms have been represented as a major problem in immune compromised patients with Acquired Immune Deficiency Syndromes. Methods: Institution based comparative cross sectional study design was conducted in Gendewoyn health center, Goncha Siso Enesie woreda from March to June 2014. A structured questionnaire was administered to all participants to obtain information on socio demographic characteristics and their source of drinking water. For the laboratory test using a direct saline, Dobell’s iodine separate wet mount, formal ether concentration and modified Ziehl-Neelsen (Zn) method was applied. The minimum sample size for this quantitative study was 312. Binary and multiple logistic regressions were used to identify factors of intestinal parasite infection and odds ratios, 95% CI and p-value were computed to measure the presence and strength of associations. Results: The overall prevalence of intestinal parasite infections in pre-ART and on-ART was 53.7% and 36.5%, respectively with significant decrease of intestinal parasite in the ART era (p<0.006). Majority of Cryptosporidium species infections were found in the pre-ART patients and significantly associated for lower CD4<500 cells/mm3. Absence of toilet (AOR=1.80; 95% CI=1.090-2.975), source of water (AOR=8.260; 95% CI=4.659-14.642), rural residence (AOR=2.292, 95% CI=1.386-3.788); CD4 counts (AOR=1.559; 95% CI=1.093-2.722) HAART status: pre ART patients (AOR=2.13, CI, 1.167-3.905) have significant association with prevalence of intestinal parasite infections. Conclusion and recommendations: The most prevalent parasite in the pre-ART subjects were ova of Ascaris lumbricoides (15.7%) followed by Enteamoeba histolytica (14.8%) while on ART patients the most prevalent parasites were ova of Ascaris lumbricoides (8.8%) and cyst of Enteamoeba histolytica (7.4%). The present study revealed the importance of examining pre-ART and on ART patients for intestinal parasite infections. This study reminded health professionals regarding the occurrence of these parasites in this population. Routine examination of stool samples for parasitic infections could significantly benefit pre-ART and on ART patients for early treatment.

Prevalence of intestinal opportunistic parasites infections in the University hospital of Bobo-Dioulasso, Burkina Faso.

BackgroundGastrointestinal parasites infections are widespread in Africa and their prevalence infections vary from country to country. This study aimed at assessing the prevalence of opportunistic intestinal parasites infection and other gastrointestinal parasites infection among patients attending the laboratory of Parasitology and Mycology of the University Hospital Souro Sanou of Bobo-Dioulasso.MethodsA hospital cross-sectional based study was conducted from April to August, 2012. Participants were persons whom parasitological examination of stools has been prescribed by a clinician. The stools examination methods included direct wet saline examination, lugol’s iodine staining technique, formol-ether concentration and modified Ziehl-Neelsen staining. We recorded age and sex information for each patient.ResultsThe overall prevalence of intestinal parasite infections was 65.3 % (190/291). Majority of the parasitic infections was waterborne (64.3 %) consisting of high prevalence of Cryptosporidium sp. (26.5 %) and Entamoeba histolytica/dispar (23.4 %). The prevalence of opportunistic parasites was 28.9 % and Cryptosporidium sp. was the most prevalent species followed by Blastocystis sp. (1.0 %), Cyclospora sp. (0.7 %) and Isospora belli (0.7 %). The prevalence of intestinal helminthes was 1.7 %.ConclusionsThe prevalence of intestinal parasitism in general remains high in Bobo-Dioulasso requiring the establishment of adequate diagnostic techniques, treatment and prevention.

Prevalence and Associated Risk Factors of Opportunistic Intestinal Parasites among HIV Positive and Negative Individuals in South Ethiopia: A Case Control Study

Prevalence and Associated Risk Factors of Opportunistic Intestinal Parasites among HIV Positive and Negative Individuals in South Ethiopia: A Case Control Study

Study of Acid-Base Disturbances in Patients with Liver Cirrhosis

Background and study aim: Diagnostic examination of stools for opportunistic intestinal parasites in HIV/AIDS patients is given less attention than it should be. The suspected opportunistic intestinal parasites such as Cryptosporidium parvum,Cyclospora cayentanensis, Toxoplasma gondii, Isospora belli and the symptom of explosive watery diarrhea they cause as well as others including Strongyloides stercoralis are the threat against the well-being of HIV/AIDS patients. The objective of this study is to demonstrate the indispensable necessity to free HIV/AIDS patients (who are under medical care in 3 different hospitals, Southern Ethiopia), from opportunistic intestinal parasites using diagnostic examination of stools followed by prompt curative treatment during every safety time interval. Patients and methods: Fresh stools samples from a total sample size of 710 HIV/AIDS patients were taken and examined in the parasitology laboratory, Dilla University, for the suspected intestinal opportunistic parasites. The methods employed to identify the intestinal parasites included observations in : wet mount, formalin-ether concentration technique, and permanent slide preparation as well as Baermann apparatus method for Strongyloides stercoralis. Result: Out of 710 HIV/AIDS patients examined 196 were found to be positive for 6 different species of the suspected intestinal parasites (infection rate of these parasites in the population of HIV/AIDS patients of the 3 different hospitals being 196×100/710=27.6% The six species of parasites isolated from fresh stools samples were: Ascaris lumbricoides, Strongyloides stercoralis, Entameba histolytica, Giardia lamblia, Balantidium coli, and Trichuris trichiura. Conclusion: Reasonably planned successive safety time intervals must be attended continuously by HIV/AIDS patients without interruption to utilize the services of medical care in order to avoid/ neutralize the potential opportunistic infections and reinfections; otherwise, the fulminant death can turn to be true. The safety and well-being of those HIV-infected patients who attend all the medical services & advices provided by clinical experts is not different from that of HIV-noninfected individuals without any trace of exaggeration.

Screening for Opportunistic Intestinal Parasites in HIV/AIDS Patients, Attending the Services of Medical Care in Three Different Hospitals, Southern Ethiopia

Background and study aim: Diagnostic examination of stools for opportunistic intestinal parasites in HIV/AIDS patients is given less attention than it should be. The suspected opportunistic intestinal parasites such as Cryptosporidium parvum,Cyclospora cayentanensis, Toxoplasma gondii, Isospora belli and the symptom of explosive watery diarrhea they cause as well as others including Strongyloides stercoralis are the threat against the well-being of HIV/AIDS patients. The objective of this study is to demonstrate the indispensable necessity to free HIV/AIDS patients (who are under medical care in 3 different hospitals, Southern Ethiopia), from opportunistic intestinal parasites using diagnostic examination of stools followed by prompt curative treatment during every safety time interval. Patients and methods: Fresh stools samples from a total sample size of 710 HIV/AIDS patients were taken and examined in the parasitology laboratory, Dilla University, for the suspected intestinal opportunistic parasites. The methods employed to identify the intestinal parasites included observations in : wet mount, formalin-ether concentration technique, and permanent slide preparation as well as Baermann apparatus method for Strongyloides stercoralis. Result: Out of 710 HIV/AIDS patients examined 196 were found to be positive for 6 different species of the suspected intestinal parasites (infection rate of these parasites in the population of HIV/AIDS patients of the 3 different hospitals being 196×100/710=27.6% The six species of parasites isolated from fresh stools samples were: Ascaris lumbricoides, Strongyloides stercoralis, Entameba histolytica, Giardia lamblia, Balantidium coli, and Trichuris trichiura. Conclusion: Reasonably planned successive safety time intervals must be attended continuously by HIV/AIDS patients without interruption to utilize the services of medical care in order to avoid/ neutralize the potential opportunistic infections and reinfections; otherwise, the fulminant death can turn to be true. The safety and well-being of those HIV-infected patients who attend all the medical services & advices provided by clinical experts is not different from that of HIV-noninfected individuals without any trace of exaggeration.

The magnitude and risk factors of intestinal parasitic infection in relation to Human Immunodeficiency Virus infection and immune status, at ALERT Hospital, Addis Ababa, Ethiopia

Human Immunodeficiency Virus (HIV) and intestinal parasitic infections are among the main health problems in developing countries like Ethiopia. Particularly, co-infections of these diseases would worsen the progression of HIV to Acquired Immunodeficiency Syndrome (AIDS). The purpose of this study was to determine the magnitude and risk factors for intestinal parasites in relation to HIV infection and immune status. The study was conducted in (1) HIV positive on antiretroviral therapy (ART) and (2) ART naïve HIV positive patients, and (3) HIV-negative individuals, at All African Leprosy and Tuberculosis (TB) Eradication and Rehabilitation Training Center (ALERT) hospital in Addis Ababa, Ethiopia. Study participants were interviewed using structured questionnaires to obtain socio-demographic characteristics and assess risk factors associated with intestinal parasitic infection. Intestinal parasites were identified from fecal samples by direct wet mount, formol ether concentration, and modified Ziehl–Neelsen staining techniques. The immune status was assessed by measuring whole blood CD4 T-cell count. The overall magnitude of intestinal parasite was 35.08%. This proportion was different among study groups with 39.2% (69/176), 38.83% (40/103) and 27.14% (38/140) in ART naïve HIV positives patients, in HIV negatives, and in HIV positive on ART patients respectively. HIV positive patients on ART had significantly lower magnitude of intestinal parasitic infection compared to HIV negative individuals. Intestinal helminths were significantly lower in HIV positive on ART and ART naïve patients than HIV negatives. Low monthly income, and being married, divorced or widowed were among the socio-demographic characteristics associated with intestinal parasitic infection. No association was observed between the magnitude of intestinal parasites and CD4 T-cell count. However, Cryptosporidium parvum, and Isospora belli were exclusively identified in individuals with CD4 T-cell count of ≤350 cells/mm3. Regular provision of mass preventive chemotherapy and extended health education will curb the burden of intestinal parasitic infection in the community. Emphasis should also be given to laboratory diagnosis and identification of opportunistic intestinal parasites in patients with lower CD4-Tcell count.

Risk factors for intestinal parasitosis among antiretroviral-treated HIV/AIDS patients in Ethiopia

Summary A cross-sectional survey was conducted to determine the risk factors associated with intestinal parasitosis in HIV/AIDS patients receiving antiretroviral therapy (ART). Socio-demographic information was collected and faecal samples were analysed from 384 randomly selected patients on ART. Data on CD4+ T-cell counts and World Health Organization clinical staging were obtained from the medical records at the hospital. The overall prevalence of intestinal parasitosis was 56% (95% confidence interval [CI]: 51% to 61%). No opportunistic intestinal parasites or Schistosoma haematobium eggs were detected. Unavailability of latrine and lack of hand washing with soap were associated with Entamoeba histolytica/dispar (adjusted odds ratio [AOR], 2.75; 95% CI: 1.77 to 4.27 and AOR, 2.67; 95% CI: 1.60 to 4.44, respectively) and Giardia lamblia (AOR, 2.08; 95% CI: 1.08 to 3.99 and AOR, 2.46; 95% CI: 1.06 to 5.75, respectively) infections. Intestinal parasitosis was significantly associated with low CD4 cell count (p = 0.002). In contrast, intestinal parasitic infections were not associated (p > 0.05) with the World Health Organization disease staging. In summary, poor personal hygiene and sanitation practice contributed to the high prevalence of intestinal parasitosis. Routine diagnosis for intestinal parasitic infections should be performed in patients attending ART clinics in this setting.

HIV/AIDS-Associated Opportunistic Protozoal Diarrhea

Human immunodeficiency virus (HIV) infection has altered both the epidemiology and outcome of enteric opportunistic parasitic infections. This study was done to determine the prevalence and species/genotypes of intestinal coccidian and microsporidial infections among HIV/AIDS patients with diarrhea and/or a history of diarrhea alternately with an asymptomatic interval, and their association with CD4 T cell count. This cross-sectional study was done from May 2010 to May 2011 in Shiraz University of Medical Sciences, South of Iran. A blood sample was obtained from HIV-positive patients for a CD4 T cell count upon enrollment. Sociodemographic data and a history of diarrhea were collected by interviewing 356 consecutive participants (273 males and 83 females). Whenever possible more than a fecal sample was collected from all the participants and examined for parasites using direct, physiological saline solution ethyl acetate, an acid-fast trichrome stain, nested polymerase chain reaction, and sequencing techniques for the detection, confirmation, and genotyping of Cryptosporidium spp., Cyclospora cayetanensis, Isospora belli, and intestinal microsporidia (Enterocytozoon bieneusi). The most common opportunistic and nonopportunistic pathogens were Cryptosporidium spp. (C. parvum and C. andersoni), E. bieneusi, Giardia lamblia, Sarcocystis spp., and Blastocystis homonis affecting 34, 8, 23, 1, and 14 patients, respectively. C. cayetanensis, I. belli, Enterobius vermicularis, and Hymenolepis nana were observed in few patients. A CD4 count <200 cells/μl was significantly associated with the presence of opportunistic parasites and diarrhea (p<0.05). Opportunistic intestinal parasites should be suspected in any HIV/AIDS patient with chronic diarrhea. Tropical epidemic nonopportunistic enteric parasitic infections among such patients should not be neglected in Iran.

Epidemiology, clinical, immune, and molecular profiles of microsporidiosis and cryptosporidiosis among HIV/AIDS patients

BackgroundThe objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV) symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients.MethodsIn this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women) with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl–Neelsen stainings, real-time polymerase chain reaction (PCR), immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR) and 95% confidence intervals were used to quantify the risk.ResultsOf the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and helminths, respectively. We found five genotypes of E. bieneusi: two older, NIA1 and D, and three new, KIN1, KIN2, and KIN3. Only 0.4% and 1.6% had Cryptosporidium parvum and Cryptosporidium hominis, respectively. Of the patients, 36.4%, 34.3%, 31%, and 39% had asthenia, diarrhea, a CD4 count of <100 cells/mm3, and no antiretroviral therapy (ART), respectively. The majority of those with opportunistic intestinal parasites and C. hominis, and all with C. parvum and new E. bieneusi genotypes, had diarrhea, low CD4+ counts of <100 cells/mm3, and no ART. There was a significant association between Entamoeba coli, Kaposi sarcoma, herpes zoster, chronic diarrhea, and asthenia, and the presence of 28 cases with opportunistic intestinal parasites. Rural areas, public toilets, and exposure to farm pigs were the univariate risk factors present in the 28 cases with opportunistic intestinal parasites. In logistic regression analysis, a CD4 count of <100 cells/mm3 (OR = 4.60; 95% CI 1.70–12.20; P = 0.002), no ART (OR = 5.00; 95% CI 1.90–13.20; P < 0.001), and exposure to surface water (OR = 2.90; 95% CI 1.01–8.40; P = 0.048) were identified as the significant and independent determinants for the presence of opportunistic intestinal parasites.ConclusionE. bieneusi and Cryptosporidium are becoming more prevalent in Kinshasa, Congo. Based on the findings, we recommend epidemiology surveillance and prevention by means of hygiene, the emphasis of sensitive PCR methods, and treating opportunistic intestinal parasites that may be acquired through fecal–oral transmission, surface water, normal immunity, rural area-based person–person and animal–human infection, and transmission of HIV. Therapy, including ART and treatment with fumagillin, is needed.

Opportunistic and other intestinal parasites among HIV/AIDS patients attending Gambi higher clinic in Bahir Dar city, North West Ethiopia

Objective To determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections among HIV/AIDS patients in Bahir Dar. Methods Cross-sectional study was conducted among HIV/AIDS patients attending Gambi higher clinic from April1-May 30, 2009. Convenient sampling technique was employed to identify the study subjects and hence a total of 248 subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of patients. Stool samples were examined by direct saline, iodine wet mount, formol-ether sedimentation concentration and modified Ziehl-Neelsen staining technique. Results Out of 248 enrolled in the study, 171(69.0%) (90 males and 81 females) were infected with one or more intestinal parasites. The highest rate of intestinal parasites were observed among HIV/AIDS patients (80.3%, 151/188), and the infection rate of HIV negative individuals was 33.3% (20/60). Cryptosporidum parvum (43.6%), Isospora belli (15.5%) and Blastocystis hominis (10.5%) were opportunistic parasites that were found only in HIV/AIDS patients. Conclusions Opportunistic parasite infections are common health problem among HIV/AIDS patients in the study area. Therefore, early detection and treatment of these parasites are important to improve the quality of life of HIV/AIDS patients.

Intestinal parasites infections in hospitalized AIDS patients in Kinshasa, Democratic Republic of Congo

To determine the prevalence and the species spectrum of intestinal parasites (IP) involved in hospitalized AIDS patients, a prospective observational and cross-sectional study was carried out in the four main hospitals in Kinshasa, Democratic Republic of the Congo. From November 2006 through September 2007, a single stool sample was collected from 175 hospitalized AIDS patients older than 15 years. Parasites were detected by light microscopy, including Ziehl-Neelsen, Fungi-Fluor, modified trichrome stains, and by immunofluorescence antibody tests and PCR for species diagnosis of microsporidia. At baseline, 19 patients (10.8%) were under antiretroviral therapy and 156 (89.2%) were eligible for ART. The main diagnosis for justifying hospitalization was intestinal infection associated with diarrhea in 87 out of 175 (49.7%). 47 out of 175 (26.9%) were found to harbor an IP, and 27 out of 175 (15.4%) were infected with at least one opportunistic IP (OIP). Prevalence rate for OIP were 9.7%, 5.1%, 1.7% and 0.6% for Cryptosporidium sp., Enterocytozoon bieneusi, Isospora belli and Encephalitozoon intestinalis respectively. Considering patients with diarrhea only, prevalence rate were 12.6%, 4.6%, 3.4% and 1.1% respectively. The other IP observed were Entamoeba histolytica/Entamoeba dispar in nine cases (5.1%), Ascoris lumbricoides in seven cases (4.0%), Giardia intestinalis in three cases (1.7%), hookworm in two cases (1.1%) and Trichiuris trichiura, Enterobius vermicularis, Schistosoma mansoni in one patient each (0.6%). No significant relationship was established between any individual IP and diarrhea. These results underline the importance of OIP in symptomatic AIDS patients regardless of diarrhea at the time of the hospitalisation, and showed that routine microscopic examination using stains designed for Cryptosporidium spp. or the microsporidia should be considered due to the absence of clinical markers.

Opportunistic Intestinal Protozoan Parasitic Infection in HIV Positive Patient in Jamnagar, Gujarat

The case definition of AIDS encompasses a spectrum of infections and malignancies, labelled as opportunistic infections. In recent years, numerous studies have outlined the emergence of opportunistic gastrointestinal protozoa that have caused diarrhoeal illness among HIV - AIDS patients. Purpose of present study was to determine the prevalence of opportunistic intestinal protozoal parasites in HIV positive patients with or without diarrhoea. A total of 100 stool samples of HIV positive patients were examined for protozoal parasites by microscopy. Protozoal parasites were detected in 25 HIV positive patients; in 41.37 % of patients with diarrhoea and in 2.38% of patients without diarrhoea. Isospora belli appeared to be a predominant parasite associated with diarrhoea among HIV patients. Cryptosporidium revealed of its asymptomatic carriage along with its association with acute and chronic diarrhoea. Prevalence of Microsporidia and Cyclospora cayetenensis was found to be very low. Key words: HIV; diarrhoea; opportunistic protozoa. DOI: 10.3126/saarctb.v5i1.3079 SAARC J. Tuber. Lung Dis. HIV/AIDS 2008 Vol.5(1) 21-24

Opportunistic intestinal parasites and TCD4+ cell counts in human immunodeficiency virus seropositive patients

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Opportunistic And Other Intestinal Parasitic Infections In Aids Patients, Hiv Seropositive Healthy Carriers And Hiv Seronegative Individuals In Southwest Ethiopia

Human Immunodeficiency Virus (HIV) infection leads to acquired immunodeficiency syndrome (AIDS) and major causes of morbidity and mortality of such patients are opportunistic infections caused by viral, bacterial, fungal and parasitic pathogens. To determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections among AIDS patients and HIV positive carrier individuals. Cross-sectional study was conducted among AIDS patients, HIV positive healthy carriers and HIV negative individuals in Jimma University Hospital, Mother Theresa Missionary Charity Centre, Medan Acts Projects and Mekdim HIV positive persons and AIDS orphans' national association from January to May, 2004. Convenient sampling technique was employed to identify the study subjects and hence a total of 160 subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of the patients. Stool samples were examined by direct saline, iodine wet mount, formol-ether sedimentation concentration, oocyst concentration and modified Ziehl-Neelsen staining technique. Out of 160 persons enrolled in this study 100 (62.5%) (i.e. 65 male and 35 female) were infected with one or more intestinal parasites. The highest rate 36 (69.2%) of intestinal parasites were observed among HIV/AIDS patients, followed by HIV positive healthy carriers 35 (61.4%) of and HIV negative individuals (29 (56.9%). Isospora belli 2 (3.9%), Cryptosporidum parvum 8 (15.4%), Strongyloides stercoralis 6 (11.5%) and Blastocystis 2 (3.9%) were found only in HIV/AIDS groups I. belli, C. parvum, S. stercoralis and Blastocystis are the major opportunistic intestinal parasites observed in HIV/AIDS patients. Therefore, early detection and treatment of these parasites are important to improve the quality of life of HIV/AIDS patients with diarrhoea.

Diagnóstico laboratorial de enteroparasitoses oportunistas, com ênfase nas microsporidioses humanas, em Goiânia-GO

Microsporidia are emergent and opportunistic protozoa that are responsible for diseases with high morbidity and mortality, especially among individuals with immune disorders. This study had the aim of determining the clinical-laboratory profile of these agents. In total, 723 patients were evaluated, divided into two groups: I) Immunosuppressed/immunodepressed individuals; II) Apparently immunocompetent individuals. After obtaining free informed consent, these patients were interviewed and gave fecal samples. These samples were all subjected to the HPJ, Rugai and Faust techniques and to specific staining for Coccidia and Microsporidia. The frequency of Microsporidia was 1.3% (5/393) in group I, whereas it was a quarter of this in group II. The occurrence of other opportunistic intestinal parasites was also greater in group I. It was concluded, firstly, that these agents are present in our environment and, secondly, that there is a need to improve the clinical and laboratory diagnosis, in order to define the geographic distribution of these agents in the State of Goiás and throughout Brazil.

The prevalence of intestinal parasites in paediatric diarrhoeal and non-diarrhoeal patients in Addis Ababa hospitals, with special emphasis on opportunistic parasitic infections and with insight into the demographic and socio-economic factors

Background : Opportunistic intestinal parasitic infections cause severe diarrhoea specially in infants and in immunocompromised people world wide. Objective : The objective of this study was to assess and determine the prevalence of opportunistic intestinal parasites in paediatric patients with and without diarrhoea in selected hospitals in Addis Ababa. Methods : A cross-sectional study was conducted on 222 children under five years of age who had diarrhoea and on 74 children who had no diarrhoea in selected Hospitals in Addis Ababa. Single stool specimens were collected and screened for intestinal parasitic infections by using direct and concentrated methods. The Modified Ziehl-Neelsen Staining and Modified Water-Ether Sendimentaion methods were used for detecting Coccidial parasites. Results : Of the 222 paediatric diarrhoeal patients, 61(27.5%) were found to be infected with a variety of intestinal parasites and out of 74 children without diarrhoea 11(14.9%) were found to be infected. Among the emerging opportunistic parasites detected in diarrhoeal children were Cryptosporidium parvum (8.1%), Isospora belli (2.3%) and Enterocytozoon bieneusi/ Encephalitozoon intestinalis (0.5%). Other common intestinal parasites detected were Ascaris lumbricoides (0.5%), Trichuris trichiura (0.9%), Giardia lamblia (6.3%), Entamoeba histolytica/ E. dispar (1.4%), Blastocystis hominis (5.9%) and Hymnolepis nana (0.5%). Opportunistic parasites were found to be significantly associated with diarrhoeal and non-breastfed children (p C. parvum and I. belli respectively were isolated from 83.3% and 80% of diarrhoeal children aged less than 12 months. C. paravum and I. belli infections were also higher in male children, with a prevalence of 72.2% for C. paravum and 80% for I. belli . Conclusion : This study re-affirms and confirms the previously held view that opportunistic parasites can cause diarrhoea in paediatric patients and that it is more prevalent in male, non-breastfed children. The cause of diarrhoea in paediatrics in the absence of identifiable parasitic infections suggests that other infectious agents might be responsible for the diarrhoea. The Ethiopian Journal of Health Development Vol. 20(1) 2006: 39-46

Intestinal Parasite Infestation in HIV Infected Patients

One of the major health problems among HIV-infected patients is the intestinal parasite infestations. It can be seen that intestinal helminth infestation in HIV-infected patients is common. However, the reported prevalence is usually similar to those of non HIV-infected patients in the same setting. The infestations are ordinary not opportunistic, hence, thus usually show no correlation to immune status of the patients. The suppression of immunity due to HIV infection shows no significant role in increasing the intestinal helminth infestations. On the other hand, having occult intestinal helminth infestations does also not worsen the outcome of HIV infection. Concerning the clinical manifestation, most of the helminth infestations are asymptomatic and the diagnosis is usually based on the stool examination. Treatments of the infestations as well as the outcomes are usually similar to immunocompetent host. Intestinal protozoa infestations are also important problems for HIV-infected patients. Some infections are ordinary, while the others are opportunistic infection. The important opportunistic intestinal parasites including C. parvum, I. belli, Cyclospora and the Microsporidia are found at high prevalence among the HIV-infected patients, especially in low immune cases with persistent diarrhea. Concerning the clinical manifestation, most of the infestations bring diarrhea and the diagnosis is usually based on the stool examination with special stains. The treatment of the opportunistic infection can usually get control of the present illness but not prevent the re-infection. Luckily, with the present wide distribution of HAART, the prevalence of the opportunistic intestinal protozoa infections is significantly decreased.