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Gudisa R, Khurana S, Mewara A, Datta P. Safeguarding health on every plate: Intestinal parasitic infection survey of food handlers in a tertiary care centre. Indian J Med Microbiol 2024; 49:100604. [PMID: 38723715 DOI: 10.1016/j.ijmmb.2024.100604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 04/10/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
Food borne infections pose significant public health problem, especially in developing countries of the world. A continuous surveillance to ensure the health of the personnel involved in preparation of the hospital food is important as they can be a source of spreading the infections and possible outbreaks. We analysed the data of the prevalence of intestinal parasitic infections in food handlers in our tertiary care centre from 2018 to 2022 and 6.8% were observed to harbour intestinal parasites during the period. This signifies the importance of routine screening, and the need of awareness and education of the food handlers in hospitals.
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Affiliation(s)
- Rajendra Gudisa
- Department of Medical Parasitology, PGIMER, Chandigarh, 160012, India.
| | - Sumeeta Khurana
- Department of Medical Parasitology, PGIMER, Chandigarh, 160012, India.
| | - Abhishek Mewara
- Department of Medical Parasitology, PGIMER, Chandigarh, 160012, India.
| | - Priya Datta
- Department of Medical Parasitology, PGIMER, Chandigarh, 160012, India.
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Prevalence of Intestinal Parasites in HIV/AIDS-Infected Patients Attending Clinics in Selected Areas of the Eastern Cape. MICROBIOLOGY RESEARCH 2022. [DOI: 10.3390/microbiolres13030040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Intestinal parasites in HIV and AIDS patients increase the risk of gastroenteritis, adding to the complexity of the virus. According to the literature, their interactions are one of the factors leading to HIV replication and progression of AIDS in Africa. Chronic immunosuppression caused by HIV infection makes people vulnerable to parasitic infections, and this is associated with a CD4+ cell count of less than 100. The study describes the prevalence of intestinal parasites in patients attending HIV/AIDS clinics in certain areas of the Eastern Cape. Methods: A cross-sectional study was conducted among 600 patients from HIV/AIDS clinics in the Eastern Cape. Tambo Municipality and Amatole Municipality were the municipalities covered. These included the Ngangalizwe Community Clinic, Tsolo Gateway Clinic, Idutywa Health Centre, and Nqamakwe Health Centre. The stools of 600 participants were examined using direct wet saline/iodine embedding, formal ether concentration technique, and modified Ziehl–Neelsen methods. Results: The mean age of the study participants was 28.2 years. They were predominantly female (79.9%), mostly single (63.6%), and lived in rural (65.2%) and urban areas (34.8%). The prevalence of intestinal parasites was determined to be 30% (180/600) after screening 600 stool samples. The most frequently detected parasites were Ascaris lumbricoides (55.9%), Balantidium coli (15.1%), Entamoeba coli (11.3%), Diphyllobothrium latum (4.3%), Taenia species (3.8%), Schistosoma mansoni (1.6%), and Cryptosporidium spp. (1.6%). Males were affected more frequently (39.2%) than females (27.9%). The difference was statistically significant (p = 0.017). Among the identified intestinal parasites, A. lumbricoides, B. coli, and Taenia spp. were found at all four sites. Conclusion: This study has shed light on the high burden of intestinal parasites in HIV/AIDS patients in the Eastern Cape. Medication adherence, deworming, and sanitary hygiene practices are needed to enhance the control of infection in the affected communities and hence contribute to the control of the HIV pandemic.
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Mesfun MG, Fuchs A, Holtfreter MC, Tufa TB, Orth HM, Luedde T, Feldt T. The implementation of the Kinyoun staining technique in a resource-limited setting is feasible and reveals a high prevalence of intestinal cryptosporidiosis in HIV patients. Int J Infect Dis 2022; 122:130-135. [PMID: 35562040 DOI: 10.1016/j.ijid.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES In resource-limited settings, intestinal Cryptosporidia or coccidian infections are common causes of chronic diarrhoea, but usually remain undiagnosed by routine stool investigation. Here, the addition of the Kinyoun staining technique after stool concentration was evaluated as an easy and inexpensive method for diagnosis of intestinal parasitic infection in HIV-infected patients. METHODS This cross-sectional study investigated HIV-infected patients with diarrhoea and randomly selected HIV-infected patients without diarrhoea as controls. Stool samples were examined by wet mount microscopy and Kinyoun staining after stool concentration. Clinical, sociodemographic and behavioural data were collected. Statistical analysis was performed using Chi-squared test and multivariate regression analysis. RESULTS In total, 163 participants were included (62.0% female, mean age 38.2 [SD ±10.7] years). Diarrhoea was present in 52.1% (85/163). The prevalence of intestinal parasites was 18.4% (30/163). Cryptosporidia infections were more frequent among patients with diarrhoea (12.9% [11/85] vs. 1.3% [1/78], p=0.005) and in patients with CD4+ cell count <200 cells/µL (25.9% [7/27] vs. 3.7% [5/136], p=0.001). Risk factors for intestinal parasitic infections were diarrhoea and the habit of regularly eating uncooked food. Kinyoun staining was necessary for detection of cryptosporidiosis. CONCLUSION In our cohort, the prevalence of intestinal parasitic infection was high, especially after additional utilization of Kinyoun staining for detection of Cryptosporidia or intestinal coccidia. Considering its clinical relevance particularly in individuals at risk, the implementation of this technique should be considered in resource-limited settings.
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Affiliation(s)
- Million Getachew Mesfun
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia; Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Heinrich Heine University, Moorenstr. 5, 40225 Duesseldorf, Germany; College of Health Sciences, Arsi University, P.O. Box 04, Asella, Ethiopia.
| | - Andre Fuchs
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia; Internal Medicine III - Gastroenterology and Infectious Diseases, University Hospital of Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany
| | - Martha Charlotte Holtfreter
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Heinrich Heine University, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Tafese Beyene Tufa
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia; Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Heinrich Heine University, Moorenstr. 5, 40225 Duesseldorf, Germany; College of Health Sciences, Arsi University, P.O. Box 04, Asella, Ethiopia
| | - Hans Martin Orth
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia; Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Heinrich Heine University, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Tom Luedde
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia; Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Heinrich Heine University, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Torsten Feldt
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia; Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Heinrich Heine University, Moorenstr. 5, 40225 Duesseldorf, Germany
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Intestinal Parasite Infestation in HIV Infected Patients in Tertiary Care Center. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.3.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Every year, the number of people living with HIV rises as a consequence of advanced infections and the positive effects of highly active antiretroviral therapy (HAART). Gastrointestinal involvement is common, with 90% of patients seeking treatment for gastrointestinal problems as their HIV infection progresses. Nonetheless, identifying and characterization of infectious agents is important for patient management by excluding a clinical diagnosis and determining appropriate treatment, as well as determining public healthcare policy for true pathogen prevalence and yielding epidemiological risk factors for specific infections. The aim of this study is to evaluate the prevalence of symptomatic or asymptomatic intestinal parasitic infection among HIV or AIDS patients. For this study with 80 HIV seropositive patients being recruited from various wards and the Integrated Counseling and Testing Center (ICTC) affiliated to the microbiology department. Patients with acute and chronic diarrhea with abdominal disorder were taken as symptomatic whereas patients without these clinical complaints and who came for routine investigations were taken as asymptomatic. Firstly stool samples were analyzed by macroscopically for the presence of mucus, blood, larvae, segments of tapeworm and adult worms. The consistencies of stool were also recorded such as formed, watery or soft or loose with odor and color. It was examined microscopically after macroscopically for protozoan cysts and trophozoites, helminthic ova and larvae, as wet mount preparation by saline and iodine preparation as well as formal ether concentrated. For the detection of intestinal coccidian parasites, smears were prepared from stool samples and a modified Ziel-Nelseen (MZN) stain was also performed. Stool samples with the detection of parasites were informed for treatment. The prevalence of intestinal parasite was 23.75% with asymptomatic and symptomatic groups having a prevalence of 16.98% and 37.04% respectively. Out of total patients, 56.25% were male and 43.75% were female. Among the male patients, 11 (13.75%) were positive for an intestinal parasitic infection and 8 (10%) were positive among females. The age distribution data revealed that the age group 21-40 years old had the highest number of intestinal parasites, followed by 41-60, 61-80, and 0-20 years old. The most intestinal parasites were found in the young and middle-aged patients, according to this study. Different parasites were identified as Entamoeba histolytica, Taenia species, Ascaris lumbricoides, Cryptosporidium parvum and Isospora with one protozoan, two coccidian parasites and two helminthes. The most common parasite was Taenia species 6 (7.5%) followed by Entamoeba histolytica 5 (6.3%) and Cryptosporidium parvum 5 (6.3%). Intestinal parasitic infection is not uncommon in HIV seropositive patients. This study underscores the need for early diagnosis and treatment of these intestinal parasites in both symptomatic and asymptomatic HIV patients.
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Banze L, Madureira AC, Zacarias BC, Nhacupe N, Mascaro-Lazcano C, Benson CA, Schooley RT, Noormahomed EV. Coinfection of HIV-1 with Schistosoma spp. and with Intestinal Parasites in Patients Attending Boane Health Center, Maputo Province, Mozambique. EC MICROBIOLOGY 2021; 17:3-16. [PMID: 36649459 PMCID: PMC9836084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background It is hypothesized that schistosomiasis and intestinal parasites increase susceptibility to HIV-1 infection and enhance AIDS progression by immunomodulation. This study aims to compare the prevalence and risk factors for schistosomiasis and intestinal parasites in HIV-1 infected and uninfected persons and to evaluate the association between HIV-1 induced immunosuppression and risk factors for parasite infection. Methods This was a cross-sectional study conducted at Boane Health Center in Boane village, Maputo Province from April to June 2017 in 280 patients aged over 5 years. From each of 140 HIV-1 infected or 140 HIV-1 uninfected persons, demographic and clinical data were collected as well as one stool and urine sample for parasitological analysis. All stool samples were processed using direct wet mount and Ritchie method for detection of common parasites, and modified Ziehl-Neelsen staining techniques to identify Cryptosporidium spp., Cystoisospora belli and Cyclospora spp. oocysts from children stools. The urine was sedimented and analyzed for S. haematobium eggs detection. Results The overall prevalence of parasitism in the study population was 46.8% (131/280). Fifty six percent of the HIV-1 infected persons (78/140) were infected by at least one parasite compared to 38% (53/140 of the HIV-1 uninfected persons (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.2-3.3).Further, HIV-1 infected persons were more likely to be infected by S. mansoni (OR 5.6, 95% CI 1.8-15.8) when compared to HIV-1 uninfected person and HIV-1 infected women were more likely to be infected by S. mansoni (OR 6.7 CI 95% 1.8-22.8%) when compared to HIV-1 uninfected women (p< 0.001). HIV-1 serostatus (OR 7.0, 95% CI 1.5-31.2). Multivariate logistic regression revealed that HIV-1 infected status (OR=1.813575), the use of river or lake as water sources either for drinking (OR=7.289245) or domestic chores (OR=9.16205) were significant risk factor for parasitic infection. Partcipants with secondary and higher school (OR=0.379) were less likely to have a parasitic infection compared with primary school or illiterate participants. Conclusions It is possible that the a high prevalence of schistosomiais and intestinal parasites in this region plays an important role on the transmission and pathogenesis of HIV.
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Affiliation(s)
- Lucas Banze
- Department of Microbiology, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute for Health Education and Research, Maputo, Mozambique
| | | | - Borges Cerveja Zacarias
- Department of Microbiology, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute for Health Education and Research, Maputo, Mozambique
| | - Noémia Nhacupe
- Department of Microbiology, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute for Health Education and Research, Maputo, Mozambique
| | | | - Constance A Benson
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, USA
| | - Robert T Schooley
- Department of Medicine, Infectious Diseases Division, University of California, San Diego, USA
| | - Emilia Virginia Noormahomed
- Department of Microbiology, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute for Health Education and Research, Maputo, Mozambique
- Department of Medicine, Infectious Diseases Division, University of California, San Diego, USA
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Betancourth S, Archaga O, Moncada W, Rodríguez V, Fontecha G. First Molecular Characterization of Cryptosporidium spp. in Patients Living with HIV in Honduras. Pathogens 2021; 10:pathogens10030336. [PMID: 33805766 PMCID: PMC8000384 DOI: 10.3390/pathogens10030336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/16/2021] [Accepted: 03/02/2021] [Indexed: 11/17/2022] Open
Abstract
Cryptosporidiosis is one of the most important causes of gastroenteritis in the world, especially in low- and middle-income countries. It is caused by the Apicomplexan parasite Cryptosporidium spp., and mainly affects children and immunocompromised people, in whom it can pose a serious threat to their health, or even be life threatening. In Honduras, there are no data on parasite species or on molecular diversity or Cryptosporidium subtypes. Therefore, a cross-sectional study was conducted between September 2019 and March 2020 for the molecular identification of Cryptosporidium spp. in 102 patients living with HIV who attended a national hospital in Tegucigalpa. Stool samples were analyzed by direct microscopy, acid-fast stained smears, and a rapid lateral flow immunochromatographic test. All samples that tested positive were molecularly analyzed to identify the species and subtype of the parasite using three different markers: gp60, cowp, and 18Sr. PCR products were also sequenced. Four out of 102 samples (3.92%) were positive for Cryptosporidiumparvum, and all were assigned to subtype IIa. These findings suggest a possible zoonotic transmission in this population.
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Affiliation(s)
- Sergio Betancourth
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (S.B.); (O.A.)
| | - Osman Archaga
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (S.B.); (O.A.)
| | - Wendy Moncada
- Servicio de Atención Integral para Pacientes que Viven con VIH/SIDA-Instituto Nacional Cardiopulmonar, Tegucigalpa 11101, Honduras; (W.M.); (V.R.)
| | - Vilma Rodríguez
- Servicio de Atención Integral para Pacientes que Viven con VIH/SIDA-Instituto Nacional Cardiopulmonar, Tegucigalpa 11101, Honduras; (W.M.); (V.R.)
| | - Gustavo Fontecha
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (S.B.); (O.A.)
- Correspondence: ; Tel.: +504-33935443
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Ahmadpour E, Safarpour H, Xiao L, Zarean M, Hatam-Nahavandi K, Barac A, Picot S, Rahimi MT, Rubino S, Mahami-Oskouei M, Spotin A, Nami S, Baghi HB. Cryptosporidiosis in HIV-positive patients and related risk factors: A systematic review and meta-analysis. ACTA ACUST UNITED AC 2020; 27:27. [PMID: 32351207 PMCID: PMC7191976 DOI: 10.1051/parasite/2020025] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/09/2020] [Indexed: 11/28/2022]
Abstract
Cryptosporidium is one of the major causes of diarrhea in HIV-positive patients. The aim of this study is to systematically review and meta-analyze the prevalence of Cryptosporidium in these patients. PubMed, Science Direct, Google Scholar, Web of Science, Cochrane and Ovid databases were searched for relevant studies dating from the period of 1 January 2000 to 31 December 2017. Data extraction for the included studies was performed independently by two authors. The overall pooled prevalence was calculated and subgroup analysis was performed on diagnostic methods, geographical distribution and study population. Meta-regression was performed on the year of publication, proportion of patients with diarrhea, and proportion of patients with CD4 < 200 cells/mL. One hundred and sixty-one studies and 51,123 HIV-positive participants were included. The overall pooled prevalence of Cryptosporidium infection in HIV-positive patients was 11.2% (CI95%: 9.4%–13.0%). The pooled prevalence was estimated to be 10.0% (CI95%: 8.4%–11.8%) using staining methods, 13.5% (CI95%: 8.9%–19.8%) using molecular methods, and 26.3% (CI95%: 15.0%–42.0%) using antigen detection methods. The prevalence of Cryptosporidium in HIV patients was significantly associated with the country of study. Also, there were statistical differences between the diarrhea, CD4 < 200 cells/mL, and antiretroviral therapy risk factors with Cryptosporidiosis. Thus, Cryptosporidium is a common infection in HIV-positive patients, and safe water and hand-hygiene should be implemented to prevent cryptosporidiosis occurrence in these patients.
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Affiliation(s)
- Ehsan Ahmadpour
- Research Center for Evidence Based Medicine (RCEBM), Tabriz University of Medical Sciences, 5166-15731 Tabriz, Iran - Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, 5166-15731 Tabriz, Iran
| | - Hanie Safarpour
- Student Research Committee, Tabriz University of Medical Sciences, 5166-15731 Tabriz, Iran
| | - Lihua Xiao
- College of Veterinary Medicine, South China Agricultural University, 510642 Guangzhou, China
| | - Mehdi Zarean
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, 91779-48964 Mashhad, Iran
| | | | - Aleksandra Barac
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Stephane Picot
- University Lyon, ICBMS UMR 5246 CNRS-INSA-CPE & Institute of Parasitology and Medical Mycology, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - Mohammad Taghi Rahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, 36147-73947 Shahroud, Iran
| | - Salvatore Rubino
- Department of Biomedical Sciences, University of Sassari, 07100 Sardinia, Italy
| | - Mahmoud Mahami-Oskouei
- Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, 5166-15731 Tabriz, Iran
| | - Adel Spotin
- Immunology Research Center, Tabriz University of Medical Sciences, 5166-15731 Tabriz, Iran
| | - Sanam Nami
- Drug Applied Research Center, Tabriz University of Medical Sciences, 5166-15731 Tabriz, Iran
| | - Hossein Bannazadeh Baghi
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, 5166-15731 Tabriz, Iran
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Pielok Ł, Nowak S, Kłudkowska M, Frąckowiak K, Kuszel Ł, Zmora P, Stefaniak J. Massive Cryptosporidium infections and chronic diarrhea in HIV-negative patients. Parasitol Res 2019; 118:1937-1942. [PMID: 30976968 PMCID: PMC6520477 DOI: 10.1007/s00436-019-06302-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/25/2019] [Indexed: 12/15/2022]
Abstract
Protozoa of the genus Cryptosporidium are common parasites of domestic and wild animals—mammals, birds, reptiles, and fishes. The invasive forms are thick-walled oocysts, which can be present in water supplies, on fruits, vegetables, or in the soil contaminated with feces. In this work, we describe three cases of middle-aged persons with massive Cryptosporidium hominis infection and chronic diarrhea with no immunological abnormalities and no history of previous travels to tropical countries. The lesions discovered during colonoscopy within the large intestine–cryptitis and the histopathological changes were related to massive cryptosporidiosis. All these statements indicate necessity of parasitological stool examination in cases with chronic diarrhea in which no etiological agents are detected, but not only in HIV positive individuals. Parasite’s eradication leads to symptom disappearance as well as improvement of histopathological mucosa alterations.
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Affiliation(s)
- Łukasz Pielok
- Department and Clinic of Tropical and Parasitic Diseases, Poznań University of Medical Sciences, Przybyszewskiego Street, 60-355, Poznań, Poland.
| | - Szymon Nowak
- Department and Clinic of Tropical and Parasitic Diseases, Poznań University of Medical Sciences, Przybyszewskiego Street, 60-355, Poznań, Poland
| | - Matylda Kłudkowska
- Department and Clinic of Tropical and Parasitic Diseases, Poznań University of Medical Sciences, Przybyszewskiego Street, 60-355, Poznań, Poland.,Central Laboratory of Microbiology, H. Święcicki University Hospital, Poznań, Poland
| | - Krystyna Frąckowiak
- Central Laboratory of Microbiology, H. Święcicki University Hospital, Poznań, Poland
| | - Łukasz Kuszel
- Department of Medical Genetics, Poznań University of Medical Sciences, Poznań, Poland
| | - Paweł Zmora
- Institute of Bioorganic Chemistry Polish Academy of Sciences, Poznań, Poland
| | - Jerzy Stefaniak
- Department and Clinic of Tropical and Parasitic Diseases, Poznań University of Medical Sciences, Przybyszewskiego Street, 60-355, Poznań, Poland
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Wang ZD, Liu Q, Liu HH, Li S, Zhang L, Zhao YK, Zhu XQ. Prevalence of Cryptosporidium, microsporidia and Isospora infection in HIV-infected people: a global systematic review and meta-analysis. Parasit Vectors 2018; 11:28. [PMID: 29316950 PMCID: PMC5759777 DOI: 10.1186/s13071-017-2558-x] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/27/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Diarrhea caused by opportunistic intestinal protozoa is a common problem in HIV infection. We aimed to establish the prevalence of Cryptosporidium, misrosporidia, and Isospora in HIV-infected people using a systematic review and meta-analysis, which is central to developing public policy and clinical services. METHODS We searched PubMed, ScienceDirect, Google Scholar, Embase, Chinese Web of Knowledge, Wanfang, and Chongqing VIP databases for studies reporting Cryptosporidium, microsporidia, or Isospora infection in HIV-infected people. We extracted the numbers of people with HIV and protozoa infection, and estimated the pooled prevalence of parasite infection by a random effects model. RESULTS Our research identified 131 studies that reported Cryptosporidium, microsporidia, and Isospora infection in HIV-infected people. We estimated the pooled prevalence to be 14.0% (3283/43,218; 95% CI: 13.0-15.0%) for Cryptosporidium, 11.8% (1090/18,006; 95% CI: 10.1-13.4%) for microsporidia, and 2.5% (788/105,922; 95% CI: 2.1-2.9%) for Isospora. A low prevalence of microsporidia and Isospora infection was found in high-income countries, and a high prevalence of Cryptosporidium and Isospora infection was found in sub-Saharan Africa. We also detected a high prevalence of Cryptosporidium, microsporidia, and Isospora infection in patients with diarrhea. Sensitivity analysis showed that three studies significantly affect the prevalence of Isospora, which was adjusted to 5.0% (469/8570; 95% CI: 4.1-5.9%) by excluding these studies. CONCLUSIONS Our findings suggest that HIV-infected people have a high prevalence of Cryptosporidium, microsporidia, and Isospora infection in low-income countries and patients with diarrhea, especially in sub-Saharan Africa, reinforcing the importance of routine surveillance for opportunistic intestinal protozoa in HIV-infected people.
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Affiliation(s)
- Ze-Dong Wang
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046 People’s Republic of China
| | - Quan Liu
- Military Veterinary Institute, Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Academy of Military Medical Sciences, Changchun, Jilin Province 130122 People’s Republic of China
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province 130188 People’s Republic of China
| | - Huan-Huan Liu
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province 130188 People’s Republic of China
| | - Shuang Li
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province 130188 People’s Republic of China
| | - Li Zhang
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province 130188 People’s Republic of China
| | - Yong-Kun Zhao
- Military Veterinary Institute, Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Academy of Military Medical Sciences, Changchun, Jilin Province 130122 People’s Republic of China
| | - Xing-Quan Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046 People’s Republic of China
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Cerveja BZ, Tucuzo RM, Madureira AC, Nhacupe N, Langa IA, Buene T, Banze L, Funzamo C, Noormahomed EV. Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1° De Maio Health Centre in Maputo, Mozambique. EC MICROBIOLOGY 2017; 9:231-240. [PMID: 29911204 PMCID: PMC5999047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Increased evidence suggests intestinal parasite infections, one of the major causes of morbidity and mortality in sub-Saharan Africa, increase the acquisition and progression of AIDS. OBJECTIVE The aim of this study was to determine the prevalence of HIV and intestinal parasite co-infections, the relationship to the degree of immunosuppression and the effect of antiretroviral treatment (ART) and trimethoprim-sulfamethoxazole (TS) on patients treated at 1° de Maio Health Centre in Maputo, Mozambique. METHODS A cross sectional study was conducted from December 2015 to August 2016. A total of 517 stool samples from 371 (71.8%) HIV infected and 146 (28.2%) HIV uninfected patients were examined for the presence of parasites using direct wet mount, Ritchie and modified Ziehl Neelsen techniques. A subsample of 201 stools from HIV infected patients was processed for coproantigens for the detection of Cryptosporidium spp. RESULTS Overall, 148 (28.6%) of the individuals were infected with at least one parasite. The prevalence of intestinal parasites was 98 (26.4%) and 50 (34.2%) in HIV infected and uninfected patients, respectively. This difference was not statistically significant. We identified 10 different parasites including (most frequently) Trichuris trichiura 67 (12.9%), Ascaris lumbricoides 27 (5.2%) and Entamoeba coli 40 (7.7%). Giardia intestinalis prevalence was significantly higher in HIV infected patients 12 (3.2%), p = 0.02. Parasitic intensity was higher in HIV infected patients than in HIV uninfected patients. Cryptosporidium spp. prevalence by coproantigen detection was 6% and was associated with degree of immune suppression. A CD4+ T-cell count of < 200 cells/μL was significantly associated with higher prevalence and intensity of parasitism, while ART and TS prophylaxis was associated with lower parasitic prevalence. CONCLUSIONS Our study revealed that the prevalence and intensity of intestinal parasites in HIV infected patients was related to the degree of immune suppression as assessed by CD4+ cell count, while ART and TS seemed to reduce the parasitic infection.
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Affiliation(s)
- Borges Zacarias Cerveja
- Parasitology Laboratory, Microbiology Department, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Rafael Manuel Tucuzo
- Biology Department, Sciences Faculty, Eduardo Mondlane University, Maputo, Mozambique
| | - Ana Carina Madureira
- Parasitology Laboratory, Microbiology Department, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute of Health Education and Research, Maputo, Mozambique
| | - Noémia Nhacupe
- Parasitology Laboratory, Microbiology Department, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Irene Alda Langa
- Parasitology Laboratory, Microbiology Department, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Titos Buene
- Parasitology Laboratory, Microbiology Department, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Lucas Banze
- Parasitology Laboratory, Microbiology Department, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Carlos Funzamo
- National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Emília Virgínia Noormahomed
- Parasitology Laboratory, Microbiology Department, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute of Health Education and Research, Maputo, Mozambique
- Department of Medicine, Infectious Diseases Division, University of California, San Diego, USA
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