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Seema K, Kumar A, Boipai M, Kumar M, Sharma AK. Prevalence of intestinal parasites in HIV/AIDS-infected patients with correlation to CD4+ T-cell count at hospital in Eastern India. J Family Med Prim Care 2023; 12:2884-2887. [PMID: 38186830 PMCID: PMC10771173 DOI: 10.4103/jfmpc.jfmpc_806_23] [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: 05/15/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction In developing nations, one of the most common reasons for death and illness is due to infections that are brought on by intestinal parasites. People who have HIV are more likely to contract parasites that are either well-established intestinal pathogens, like Entamoeba histolytica, Giardia lamblia and Strongyloidesstercoralis, or an opportunistic pathogen like Cryptosporidium, Isospora, Cyclospora and Microsporidia. Higher prevalence of intestinal parasitic infections occurs in patients with low CD4+ cell counts. Hence, this study had been performed to know the correlation of intestinal parasitic infection in HIV/AIDS patients with reference to CD4+ cell count. Materials and Methods The study comprised 1477 HIV-positive patients who were treated at ART Centre of Rajendra Institute of Medical Sciences (RIMS), Ranchi. All participants provided verbal informed consent before specimens were collected. Blood and stool sample were used for the identification of parasite and CD4+ T-Cell count. Results In patients living with HIV, the prevalence of intestinal parasite infection was 12.59 per cent. In a manner parallel, the prevalence of parasitic infections was found to be 10.29% among male HIV-positive patients and 2.31% among female HIV-positive patients. Conclusions This study has shed light that low CD4+ T-cell count appears to be a factor for intestinal parasitic infections and development of diarrhoea. Regular screening and treatment of intestinal parasitic infections is very important in overall improvement in quality of life of HIV/AIDS patients. Nevertheless, sanitary hygiene practices and deworming are needed to enhance the control of infection in the affected areas.
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Affiliation(s)
- Kumari Seema
- Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Abhay Kumar
- Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Manju Boipai
- Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Manoj Kumar
- Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Ashok Kumar Sharma
- Department of Microbiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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Akanksha K, Kumari A, Dutta O, Prasanth A, Deeba F, Salam N. Prevalence of soil-transmitted helminth infections in HIV patients: a systematic review and meta-analysis. Sci Rep 2023; 13:11055. [PMID: 37422549 PMCID: PMC10329649 DOI: 10.1038/s41598-023-38030-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/01/2023] [Indexed: 07/10/2023] Open
Abstract
Soil-transmitted Helminth (STH) infections have been found associated with people living with human immunodeficiency virus (HIV) but little is known about the overall burden of STH coinfection in HIV patients. We aimed to assess the burden of STH infections among HIV patients. Relevant databases were systematically searched for studies reporting the prevalence of soil-transmitted helminthic pathogens in HIV patients. Pooled estimates of each helminthic infection were calculated. The odds ratio was also determined as a measure of the association between STH infection and the HIV status of the patients. Sixty-one studies were finally included in the meta-analysis, consisting of 16,203 human subjects from all over the world. The prevalence of Ascaris lumbricoides infection in HIV patients was found to be 8% (95% CI 0.06, 0.09), the prevalence of Trichuris trichiura infection in HIV patients was found to be 5% (95% CI 0.04, 0.06), the prevalence of hookworm infection in HIV patients was found to be 5% (95% CI 0.04, 0.06), and prevalence of Strongyloides stercoralis infection in HIV patients was found to be 5% (95% CI 0.04, 0.05). Countries from Sub-Saharan Africa, Latin America & Caribbean and Asia were identified with the highest burden of STH-HIV coinfection. Our analysis indicated that people living with HIV have a higher chance of developing Strongyloides stercoralis infections and decreased odds of developing hookworm infections. Our findings suggest a moderate level of prevalence of STH infections among people living with HIV. The endemicity of STH infections and HIV status both are partially responsible for the burden of STH-HIV coinfections.
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Affiliation(s)
- Kumari Akanksha
- Department of Microbiology, Central University of Punjab, Bathinda, Punjab, 151401, India
| | - Ashu Kumari
- Department of Microbiology, Central University of Punjab, Bathinda, Punjab, 151401, India
| | - Omprokash Dutta
- Department of Microbiology, Central University of Punjab, Bathinda, Punjab, 151401, India
| | - Ajay Prasanth
- Department of Microbiology, Central University of Punjab, Bathinda, Punjab, 151401, India
| | - Farah Deeba
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi, 110025, India
| | - Nasir Salam
- Department of Microbiology, Central University of Punjab, Bathinda, Punjab, 151401, India.
- Department of Biosciences, Jamia Millia Islamia, New Delhi, 110025, India.
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Ntonifor NH, Tamufor ASW, Abongwa LE. Prevalence of intestinal parasites and associated risk factors in HIV positive and negative patients in Northwest Region, Cameroon. Sci Rep 2022; 12:16747. [PMID: 36202863 PMCID: PMC9537173 DOI: 10.1038/s41598-022-20570-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/15/2022] [Indexed: 11/10/2022] Open
Abstract
Epidemiological understanding of intestinal parasitic infections is essential for the effective management of HIV infection. Therefore, this study was designed to assess the burden of intestinal parasites and associated risk factors. A cross-sectional study was conducted from May to December 2020 during which 200 HIV positive and 200 HIV negative participants were recruited. A total of 400 stool and venous blood samples were collected and used to identify the different intestinal parasites and for HIV diagnosis and viral load determination respectively. Results obtained revealed that the overall prevalence of intestinal parasites was 11% (44/400). Intestinal parasitosis was significantly (p = 0.025) higher in HIV-positive individuals 14.5% (29/200). Similarly, the prevalence of multiple parasitic infection 4.5% (18/400) and opportunistic helminths 3% (6/400) were insignificantly (p > 0.05) higher among HIV-positive individuals. Furthermore, prevalence of intestinal parasites was significantly (p = 0.004) greater in patients with viral load of > 1000 copies/mL 24.3% (13/46). Age group > 65 years, self-employment, living in Sub-urban areas, being HIV positive, primary level of education, use of potable tap water, and the use of water system toilets for faeces disposal were identified as associated risk factors to intestinal parasites. Intestinal parasites remain public health concern among patients with HIV. Prompt and effective antiretroviral treatment is required to reduce the intensity of the parasite.
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Affiliation(s)
- Ngum Helen Ntonifor
- Department of Biological Sciences, Faculty of Science, The University of Bamenda, Bambili, Cameroon.,Department of Zoology and Animal Physiology, University of Buea, Buea, South West Region, Cameroon.,African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria
| | | | - Lem Edith Abongwa
- Department of Biological Sciences, Faculty of Science, The University of Bamenda, Bambili, Cameroon. .,African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria.
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Nasrallah J, Akhoundi M, Haouchine D, Marteau A, Mantelet S, Wind P, Benamouzig R, Bouchaud O, Dhote R, Izri A. Updates on the worldwide burden of amoebiasis: A case series and literature review. J Infect Public Health 2022; 15:1134-1141. [PMID: 36155852 DOI: 10.1016/j.jiph.2022.08.013] [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: 04/27/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Amoebiasis is an intestinal and tissue parasitic infection caused by the protozoan Entamoeba histolytica. Despite significant medical importance and worldwide dispersion, little is known about the epidemiology and distinct geographical distribution of various clinical forms of amoebiasis in the world. In this study, we present an amoebiasis case series referred to Avicenne Hospital (Bobigny, France) from 2010 to 2022 followed by an overview of the released literature to explore diverse clinico-pathology of amoebiasis and to update the actual epidemiological situation of this parasitosis worldwide. METHODS The referred patients underwent a combination of clinical and parasitological examinations and imaging. The study was followed by an overview of released literature performed based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline. RESULTS A total of 15 patients with amoebiasis were diagnosed with an average age of 48.5 years old at the occurrence time of infection. Men (78%) were the most affected patients. Most of the cases were reported following a trip to endemic regions, such as Mali, India, Nepal, Algeria, Cameroon or Congo. All of the processed patients exhibited a hepatic amoebiasis. Amoebic abscess was observed in all cases with an average size of 6.3 cm. Of these patients, seven cases (46.7%) benefited from drainage following a risk of rupture or superinfection of the abscess. A compilation of findings extracted from 390 scientific publications via seven major medical databases, allowed us to update the main epidemiological and clinical events that has led to the current worldwide expansion of amoebiasis. We presented a clinical and epidemiological overview of the amoebiasis accompanied with a worldwide illustrative map displaying the current distribution of known amoebiasis foci in each geographical ecozone of Asia, Europe, Africa, Americas, and Australia. CONCLUSIONS Although Metropolitan France is not known as an endemic region of amoebiasis, amoebic liver abscess was the most frequent clinical form observed among our 15 patients processed. Most of infected patients had a history of travel to or lived-in endemic areas before arriving in France.
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Affiliation(s)
- Jade Nasrallah
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Mohammad Akhoundi
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France.
| | - Djamel Haouchine
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Anthony Marteau
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Stéphane Mantelet
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Philippe Wind
- Digestive Surgery and Surgical Oncology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Robert Benamouzig
- Hepato-gastroenterology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Olivier Bouchaud
- Infectious diseases Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord, Bobigny, France
| | - Robin Dhote
- Internal Medicine Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Arezki Izri
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France; Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France
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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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Feleke DG, Ali A, Bisetegn H, Andualem M. Intestinal parasitic infections and associated factors among people living with HIV attending Dessie Referral Hospital, Dessie town, North-east Ethiopia: a cross-sectional study. AIDS Res Ther 2022; 19:19. [PMID: 35443715 PMCID: PMC9022254 DOI: 10.1186/s12981-022-00443-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Intestinal parasites and HIV/AIDS co-infection become a major public health concern in Africa. The management and care of HIV/AIDS patients is being complicated by intestinal parasitic infections. Therefore, this study aimed to determine the prevalence and associated factors of intestinal parasitic infections among people living with HIV at Dessie Referral Hospital, North-east Ethiopia. METHODS This cross sectional study was conducted from March to May 2019. Systematic simple random sampling technique was used to recruit study participants. Stool specimen was collected and examined microscopically using wet mount, formol-ether concentration technique and modified Zeihl-Neelsen methods. Socio-demographic characteristics and associated factors were collected using structured questionnaire. The recent CD4 cell count was obtained from patients ART follow-up record. Data were analysed using SPSS version 20 software. Bivariate and multivariate logistic regression was done to investigate the association between independent and dependent variables. RESULTS Of the total of 223 study participants 120 (53.8%) were females and 162 (72.6%) were urban resident. The overall prevalence of intestinal parasites was 47 (21.1%). Eleven different intestinal parasites species were detected. The dominant intestinal parasite species was Entameoba histolytica 14 (6.3%) followed by Enterobius vermicularis 5 (2.2%). Multivariate logistic regression analysis showed that individuals who had a habit of hand washing after latrine were less likely to be infected with intestinal parasitic infection (AOR 0.15, 95% CI 0.05-0.412). On the other hand individuals who had CD4 cell count of < 200 cells/ml3 were 45.53 times more likely infected with intestinal parasites. CONCLUSION The prevalence of intestinal parasite was higher than previous report from the same study area almost a decade ago. There was statistical significant association between hand washing habit after latrine, habit of eating raw vegetables and CD4 cell count less than 200 cells/ml3 and intestinal parasitic infections. Health education program interrupted in Dessie referral hospital should be continued to reduce the prevalence of intestinal parasites. Utilization of water treatment, washing hand after latrine and eating cooked or appropriately washed vegetables should also be promoted. Moreover, periodic laboratory stool specimen examination and prompt treatment are necessary.
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Akalu TY, Aynalem YA, Shiferaw WS, Merkeb Alamneh Y, Getnet A, Abebaw A, Atnaf A, Abate A, Tilahun M, Kassie B, Aschale Y. National burden of intestinal parasitic infections and its determinants among people living with HIV/AIDS on anti-retroviral therapy in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2022; 10:20503121221082447. [PMID: 35284074 PMCID: PMC8908390 DOI: 10.1177/20503121221082447] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/03/2022] [Indexed: 01/21/2023] Open
Abstract
Objectives: The aim of this systematic review and meta-analysis is designed to assess the pooled prevalence and determine risk factors of intestinal parasitic infections among people living with HIV/AIDS on anti-retroviral therapy in Ethiopia. Methods: International databases: PubMed, Web of Science, Cochrane Library, Scopus, PsycINFO, African Journals Online, and Google Scholar were systematically searched. Publication bias was determined using the funnel plot and Egger’s regression tests. Heterogeneity between the studies included in this review was checked by I2 statistic. The DerSimonian and Laird random-effects model was applied to estimate the pooled effect size. Sub-group, meta-regression, and sensitivity analysis were conducted. Overall, meta-analysis was done using Stata version 14 statistical software. Results: Twenty-seven studies with 8946 individuals were included, the estimated pooled prevalence of intestinal parasitic infections among people living with HIV/AIDS on anti-retroviral therapy was 40.24% (95% confidence interval = 33.8–46.6). Based on sub-group analysis, the highest prevalence was observed in the Tigray region 45.7% (95% confidence interval = 7.9–83.5), followed by Oromia region 42.2% (95% confidence interval = 28.8–55.6). Availability of latrine (odds ratio = 26.6, 95% confidence interval = 2.8–15.8), presence of animals at home (odds ratio = 2.7, 95% confidence interval = 1.2–5.8), and source of drinking water (odds ratio = 3.2, 95% confidence interval = 1.3–7.5) were significantly associated with intestinal parasitic infections. Conclusion: These findings indicated that the prevalence of intestinal parasites among people living with HIV/AIDS was high in Ethiopia.
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Affiliation(s)
| | | | | | | | - Asmamaw Getnet
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Abtie Abebaw
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Aytenew Atnaf
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Abebe Abate
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Melkamu Tilahun
- School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Bekalu Kassie
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Yibeltal Aschale
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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Purbey MK, Singh A, Kumari S, Banerjee T. High carriage rate of intestinal parasites among asymptomatic HIV-seropositive individuals on antiretroviral therapy attending the tertiary care hospital in Varanasi, India. Indian J Sex Transm Dis AIDS 2021; 42:101-105. [PMID: 34909612 PMCID: PMC8628098 DOI: 10.4103/ijstd.ijstd_39_18] [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: 05/23/2018] [Revised: 12/22/2019] [Accepted: 03/24/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction Infections by intestinal parasites (IPs) are prevalent among human immunodeficiency virus (HIV)-seropositive individuals. Although diarrhea is the usual manifestation, asymptomatic presentations are common. In such situations, the problem of parasitosis is often underestimated. This study was performed to assess the presence of IPs among asymptomatic HIV-seropositive patients. Materials and Methods A case-control study was designed, including stool samples from 75 asymptomatic HIV-seropositive patients and 75 seronegative patients with gastrointestinal discomfort. IPs was identified by microscopy and polymerase chain reaction (PCR) for Entamoeba spp, Cryptosporidium and Microsporidium spp. The data were statistically analyzed using the Chi-square test. Results The prevalence of IPs in HIV-seropositive cases (25.33%) was statistically significantly more (P < 0.05) than that of controls (4%). Helminths predominated in both the groups. PCR detected IPs in 5 (6.6%) additional microscopy-negative cases. The presence of IPs was associated with CD4 count <200 cells/μl. Conclusion The asymptomatic carriage of IPs in HIV patients poses an important reservoir in the community. To prevent transmission, frequent screening is needed.
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Affiliation(s)
- Manish Kumar Purbey
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Aradhana Singh
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Simmi Kumari
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Tuhina Banerjee
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Dereb E, Negash M, Teklu T, Damtie D, Abere A, Kebede F, Ewnetu Y, Kasa E. Intestinal Parasitosis and its Association with CD4+ T Cell Count and Viral Load among People Living with HIV in Parasite Endemic Settings of Northwest Ethiopia. HIV AIDS (Auckl) 2021; 13:1055-1065. [PMID: 34938125 PMCID: PMC8685387 DOI: 10.2147/hiv.s328269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/12/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To study intestinal parasitosis and its association with viral load and CD4+ T cell count in HIV-infected individuals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Methods A cross-sectional study was conducted from March to June 2019. Three hundred and sixteen study participants were selected using systematic random sampling technique. Sociodemographic and clinical data were collected using structured questionnaire. Stool samples were collected and examined using direct saline, formol ether concentration technique and modified acid fast staining. CD4+ T cell counts and viral load were determined by fluorescence-activated cell sorting (BD FACS) and COBAS Ampliprep/COBAS TaqMan HI2CAP assay, respectively. Data were entered into Epi Data 3.1 and transferred to SPSS version 20 software for analysis. Bivariable and multivariable analyses were performed using a binary logistic regression model. P values of less than 0.05 were considered statistically significant. Results The overall prevalence of intestinal parasitosis was 24.7% (78/316). The most commonly detected parasite was Cryptosporidium species with 5.4% (17/316), followed by Ascaris lumbricoides with 5.1% (16/316). There was a significant association with low CD4+ T cell count (AOR: 3.207; 95% CI: 1.237, 8.317), high viral load (AOR: 2.933; 95% CI: 1.326, 6.489), individuals aged 31–40 years (AOR: 0.305; 95% CI: 0.124, 0.751) and individuals aged 41–50 years (AOR: 0.261; 95% CI: 0.101, 0.671). Conclusion In this study, prevalence of intestinal parasitic infections was high and was associated with low CD4+ T cell count and high viral load. Therefore, screening of HIV patients, especially those with low CD4+ T-cell count and high viral load, particularly for opportunistic intestinal parasitic infections would be of utmost importance in the efforts to prevent and control opportunistic infections in HIV patients.
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Affiliation(s)
- Eseye Dereb
- University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Markos Negash
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Takele Teklu
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Medical Laboratory Sciences, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita, Ethiopia
- Correspondence: Takele Teklu Tel +251 911-806643Fax +251 46-5514417 Email
| | - Debasu Damtie
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- The Ohio State University Global One Health LLC, Eastern Africa Regional Office, Addis Ababa, Ethiopia
| | - Aberham Abere
- Department of Medical Parasitology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Firehiwot Kebede
- University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Yalemwork Ewnetu
- University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Eyuel Kasa
- University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia
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Mahdavi F, Shams M, Sadrebazzaz A, Shamsi L, Omidian M, Asghari A, Hassanipour S, Salemi AM. Global prevalence and associated risk factors of diarrheagenic Giardia duodenalis in HIV/AIDS patients: A systematic review and meta-analysis. Microb Pathog 2021; 160:105202. [PMID: 34562555 DOI: 10.1016/j.micpath.2021.105202] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022]
Abstract
Giardia duodenalis is one of the leading causes of diarrhea, mostly in underdeveloped nations of Africa and Asia. The present review provides insights into the prevalence, odds ratios (ORs) and associated risk factors of giardiasis in HIV/AIDS patients. Four major English databases (Web of Science, PubMed, Scopus, and Google Scholar) were excavated for relevant literature without time limitation until 20 November 2020. Next, meta-analysis was performed using a random-effects model and 95% confidence intervals (CIs). As well, heterogeneity among studies was evaluated using Cochran's Q and the I2-statistic. Totally, 19,218 HIV/AIDS patients in 130 studies were examined, showing a 5% (95% CI: 4.2%-6%) pooled prevalence. Also, the weighted random-effects OR of G. duodenalis infection among HIV/AIDS patients in comparison with their controls in 48 case-control studies was estimated as 1.71% (95% CI: 1.1%-2.66%, p = 0.016). Based on sensitivity analysis, there was no remarkable variation in the pooled OR upon omitting individual studies. Diarrhea was a potent risk factor, since HIV/AIDS patients with diarrhea were 3.8-times (95% CI: 1.6-8.9, p = 0.002) more prone to G. duodenalis infection than those without diarrhea. Moreover, the prevalence of the parasitic infection was 1.2-times higher in patients without antiretroviral therapy (ART) than those with ART (p = 0.312). Meta-regression was employed to evaluate the possible association between G. duodenalis frequency in HIV/AIDS patients and some variables such as sample size, publication year, and HDI. Additionally, the pooled prevalence of G. duodenalis infection was estimated based on several subgroups, including publication years, WHO regions, countries, continents, country incomes, and CD4+ T-cell levels. Altogether, the epidemiology of giardiasis in HIV/AIDS patients and its association with various risk factors is still open to question and requires more detailed and comprehensive investigations.
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Affiliation(s)
- Farzad Mahdavi
- Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
| | - Morteza Shams
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran.
| | - Alireza Sadrebazzaz
- Razi Vaccine & Serum Research Institute, Agricultural Research, Education and Extension Organization, Mashhad, Iran.
| | - Laya Shamsi
- Department of Pathobiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
| | - Mostafa Omidian
- Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ali Asghari
- Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
| | - Amir Masoud Salemi
- Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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11
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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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12
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Getachew T, Hailu T, Alemu M. Prevalence of Opportunistic Intestinal Parasitic Infections Among HIV/AIDS Patients Before and After Commencement of Antiretroviral Treatment at Felege Hiwot Referral Hospital: A Follow-up Study. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2021; 13:767-774. [PMID: 34295192 PMCID: PMC8291584 DOI: 10.2147/hiv.s318538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/08/2021] [Indexed: 11/23/2022]
Abstract
Background Coccidian parasites are opportunistic intestinal parasites that cause diarrhea in immunocompromised individuals. Although the impacts of coccidian infection are significant among HIV/AIDS infected cases, proper diagnosis and management of coccidian infection is limited in sub-Saharan Africa including Ethiopia. Objective The aim of this study was to determine the prevalence of coccidian parasitic infections among HIV/AIDS cases before and after commencement of antiretroviral treatment. Methods An institution-based longitudinal study was conducted among 304 randomly selected HIV/AIDS cases from February to July 2018 before and after commencement of antiretroviral therapy. A structured questionnaire was used to collect sociodemographic and associated factors data. Stool and blood samples were collected before and three months after treatment. Coccidian detection and CD4+ count were conducted via modified acid fast stain technique and fluorescence-activated cell scanning, respectively. Data were entered and analyzed using SPSS version 20. Descriptive statistics were used to compute coccidian prevalence. Logistic regression was used to compute possible association between associated factors and coccidian parasitic infection. Variables with P<0.05 were considered to be statistically significant. Results Among 304 HIV/AIDS cases, prevalence of coccidian parasitic infection before and after antiretroviral treatment was 23.4% and 8.9%, respectively. Prevalence of Cryptosporidium spp. (19.7%) and Isospora belli (4.3%) before antiretroviral treatment were higher than Cryptosporidium spp. (7.9%) and Isospora belli (1.0%) after treatment. Drinking unprotected water (AOR: 7.41; 95%CI: 1.64–33.45), poor knowledge of HIV/AIDS and coccidian parasite (AOR: 4.19; 95%CI: 1.69–10.40), and CD4+ count below 200 cells/mm3 (AOR: 62.49; 95%CI: 25.32–154.21) were significantly associated with coccidian infection. Conclusion Prevalence of coccidian parasites among HIV/AIDS cases decreases after antiretroviral treatment. Drinking unsafe water, limited knowledge of HIV/AIDS and coccidian parasite and low CD4+ cell count are factors associated with coccidian infection. Therefore, proper detection and treatment of coccidian parasites among HIV/AIDS cases should be prioritized.
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Affiliation(s)
| | - Tadesse Hailu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Megbaru Alemu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Miressa R, Dufera M. Prevalence and Predisposing Factors of Intestinal Parasitic Infections Among HIV Positive Patients Visiting Nekemte Specialized Hospital, Western Ethiopia. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2021; 13:505-512. [PMID: 34017200 PMCID: PMC8131008 DOI: 10.2147/hiv.s304294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/24/2021] [Indexed: 11/23/2022]
Abstract
Background Intestinal parasites are endemic in many regions of the world where Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) patients are prevalent. This study aimed to assess the extent of intestinal parasitic infection (IPI) and predisposing factors among HIV positive patients visiting Nekemte Specialized Hospital, Western Ethiopia. Methods A hospital-based cross-sectional study was conducted among HIV positive patients and HIV negative controls who visited Nekemte Specialized Hospital from April to August 2020. A structured questionnaire was used to collect socio-demographic and risk-factor data. Stool samples and blood were collected and tested. Data were analyzed using SPSS version 20. P<0.05 was considered statistically significant. Results The occurrence of IPIs was considerably higher (73.3%) among HIV positive subjects compared to HIV negative controls (22.7%). Rate of infection with IPI was higher in individuals with CD4+ T cell count < 200 cells/μL. The species-specific distribution of parasites among HIV positive was higher for Giardia lamblia 35% followed by Entamoeba histolytica, 16% and hookworm 17.5%. Among the risk factors; age, educational status and occupation were significantly related with IPI (P<0.05). Habit of washing hands (OR=1.146, 95% CI: 0.189–1.936) and contact with animals (OR=2.926, 95% CI: 1.955–4.380) were expressively associated with IPI. Furthermore, eating raw meat, lack of safe water sources and usage were meaningfully connected with IPIs with OR=1.203, 95% CI: 0.590–2.454 and OR=0.172, 95% CI: 0.112–0.263, respectively. Conclusion HIV positive individuals were highly affected by IPI than HIV negative controls. The spreading of intestinal parasites was critically affected by reduced CD4+ T cell counts. Consistent screening and treatment of IPIs and awareness creation is very vital in improving the overall quality life of HIV/AIDS patients.
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Affiliation(s)
- Robsen Miressa
- Department of Biology, College of Natural and Computational Sciences, Wollega University, Nekemte, Ethiopia
| | - Mebrate Dufera
- Department of Biology, College of Natural and Computational Sciences, Wollega University, Nekemte, Ethiopia
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Bayleyegn B, Woldu B, Yalew A, Kasew D, Asrie F. Prevalence of Intestinal Parasitic Infection and Associated Factors Among HAART Initiated Children Attending at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. HIV AIDS (Auckl) 2021; 13:81-90. [PMID: 33531842 PMCID: PMC7846865 DOI: 10.2147/hiv.s287659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/12/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) and intestinal parasites co-infections are the most common causes of clinical illness and death, especially for children living in resource constrained setting. Therefore, the aim of this study was to determine the prevalence and associated factors of intestinal parasites among highly active anti-retroviral therapy (HAART) initiated children. METHODS Cross-sectional study was conducted among 255 HAART initiated HIV-infected children at the University of Gondar Comprehensive Specialized Hospital from January to April 2020. Socio-demographic characteristics were collected using a structured questionnaire via a face-to-face interview. Clinical data of the children were collected by reviewing the medical records. Venous blood was collected for complete blood counts, viral load determination, and blood film examination. Flotation concentration technique was done in addition to direct wet mount for parasitological examination. Bi-variable and multi-variable logistic regression analysis were used to check the presence of significant association, and P-value<0.05 was considered as statistically significant. RESULTS The overall prevalence of intestinal parasite infection (IPI) among the study participants was 22.4% (95% CI=17-28%). The presence of opportunistic infection (AOR=2.09 95% CI=1.81-5.43), no eating under-cooked animal products (AOR=0.38 95% CI=0.16-0.94), male sex (AOR=0.45 95% CI=0.22-0.90), viral load rate >1,000 copies/mL (AOR=1.80 95% CI=1.67-4.19), and cytopenia (AOR=2.71 95% CI=1.59-12.25) showed significant association with the prevalence of IPI. CONCLUSION Entamoeba histolytica and Ascaris lumbricoides were the most prevalent intestinal parasites among HAART initiated children. Among HAART initiated children, IPI were associated with gender, cytopenia, viral load, undercooked animal products, and the presence of opportunistic infections. Therefore, health education, prompt treatment, and regular deworming should be implemented to alleviate the burden of intestinal parasites in HIV-infected children.
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Affiliation(s)
- Biruk Bayleyegn
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Berhanu Woldu
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Aregawi Yalew
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Desie Kasew
- Department of Medical Microbiology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fikir Asrie
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Mekachie Sandie S, Sumbele IUN, Tasah MM, Kimbi HK. Malaria and intestinal parasite co-infection and its association with anaemia among people living with HIV in Buea, Southwest Cameroon: A community-based retrospective cohort study. PLoS One 2021; 16:e0245743. [PMID: 33481933 PMCID: PMC7822292 DOI: 10.1371/journal.pone.0245743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 01/06/2021] [Indexed: 12/20/2022] Open
Abstract
Background Both malaria and intestinal parasites are endemic in Cameroon, and their co-infection can be of great impact on anaemia among people living with HIV (PLWH). This community-based retrospective cohort study determined the prevalence and association of infections with anaemia in PLWH and HIV-negative individuals in Buea, Cameroon from March to August 2019. Methods The study population comprised of 190 PLWH and 216 consenting HIV-negative individuals from the Buea community. Participants were examined clinically, the collected blood sample was used for malaria parasite (MP) detection, HIV diagnosis and haemoglobin (Hb) measurement while stool samples were examined for the detection of intestinal parasites (IPs). Proportions were compared using Pearson’s Chi-square test and association of anaemia with independent variables was evaluated using logistic regression analysis. Results Out of the 406 participants, MP, IPs and MP/IP co-infection prevalences were 15.5%, 13.0% and 3.0% respectively. PLWH had a higher prevalence of MP (16.3%, P = 0.17), IPs (23.7%, P ˂ 0.001) and MP/IPs co-infection (3.7%, P = 0.04) when compared with HIV-negative participants. Similarly, PLWH had significantly lower mean haemoglobin value (11.10 ± 1.54 g/dL) than their HIV-negative counterparts (12.45 ± 2.06 g/dL). Also, PLWH co-infected with MP and IPs were observed to have a significantly lower mean haemoglobin value (10.6 ± 1.21 g/dL). PLWH had a significantly (P ˂ 0.001) higher prevalence of mild (56.8%), moderate (18.4%) and severe (1.6%) anaemia when compared with HIV-negative counterparts. The significant risk factors associated with anaemia included being febrile (P = 0.03), MP-infected only (P = 0.001), HIV-infected only (P < 0.001), having dual (P < 0.001) or triple-infections (P = 0.03). Conclusion Malaria and intestinal parasites remain public health concerns among PLWH and anaemia as a serious haematological abnormality gets exacerbated even with the viral load suppression. Hence, routine medical check-ups among PLWH are recommended.
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Affiliation(s)
| | - Irene Ule Ngole Sumbele
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
- Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Martin Mih Tasah
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
| | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
- Department of Medical Laboratory Science, The University of Bamenda, Bambili, Cameroon
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16
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Belay A, Ashagrie M, Seyoum B, Alemu M, Tsegaye A. Prevalence of enteric pathogens, intestinal parasites and resistance profile of bacterial isolates among HIV infected and non-infected diarrheic patients in Dessie Town, Northeast Ethiopia. PLoS One 2020; 15:e0243479. [PMID: 33320909 PMCID: PMC7737993 DOI: 10.1371/journal.pone.0243479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/21/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Enteric pathogens like Salmonella and Shigella species as well as intestinal parasites (IPs) are among the main causative agents of diarrhea in people with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), particularly in low income countries like Ethiopia. Antimicrobial resistance against commonly prescribed drugs has become a major global threat. This study, therefore, aimed at determining the magnitude of Salmonella, Shigella and IPs infections, their predicting factors, and antimicrobial susceptibility pattern among HIV infected and non-infected diarrheic patients in Dessie town, Northeast Ethiopia. METHODS A cross sectional study was conducted at three health facilities in Northeast Ethiopia between January 2018 and March 2018. Data on socio-demographic and associated risk factors were collected using structured questionnaire from 354 HIV infected and non-infected diarrheic outpatients. Fresh stool specimen was processed according to standard operating procedures. Data were entered and analyzed using SPSS version 22. Descriptive statistics was used to determine frequency, Bivariate and multivariate logistic regression analyses were performed to identify predicting factors associated with the outcome variable. P-value <0.05 were used to declare statistical significance. RESULTS Among 354 diarrheic patients, 112 were HIV infected and 242 were HIV non-infected. The overall prevalence of intestinal parasite and bacterial infection among HIV infected versus non-infected, respectively, was 26 (23.2%) and 8 (7.1%) versus 50 (20.7) and 16 (6.6%). Salmonella was the highest in both groups, 6 (5.4%) vs 11 (4.5%). Most prevalent parasite was C. parvum, 9 (8%) among HIV+ while E. histolytica/dispar 39 (16.1%) among HIV-. Having bloody plus mucoid diarrhea, not utilizing latrine and drinking river or spring water were factors significantly associated with bacterial infection. Whereas, being illiterate or having primary level education, diarrhea lasting for 6-10 days, CD4 level between 200-500 cells/μl, not washing hand with soap showed significant association with IPs. The bacterial isolates were 100% susceptible to Ceftriaxone and 95.4% to Ciprofloxacin, while 100% resistant to Ampicillin and Amoxicillin. MDR was observed among 19 (79.2%) isolates. CONCLUSION Preventing and controlling infection by enteric pathogens as well as IPs require strengthening intervention measures. The 100% resistance of isolates to commonly prescribed antibiotics calls for expanding antimicrobial susceptibility testing so as to select appropriate antimicrobial agent and prevent emergence of drug resistant bacteria.
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Affiliation(s)
- Assefa Belay
- Department of Medical Laboratory Sciences, Dessie Health Science College, Dessie, Ethiopia
| | - Melaku Ashagrie
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Berhanu Seyoum
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Mekuanent Alemu
- Department of Medical Laboratory Sciences, Dessie Health Science College, Dessie, Ethiopia
| | - Aster Tsegaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail: ,
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Ayele A, Tadesse D, Manilal A, Yohanes T, Seid M, Shewangizaw Mekuria M. Prevalence of enteric bacteria and enteroparasites in human immunodeficiency virus-infected individuals with diarrhoea attending antiretroviral treatment clinic, Arba Minch General Hospital, southern Ethiopia. New Microbes New Infect 2020; 38:100789. [PMID: 33224508 PMCID: PMC7666345 DOI: 10.1016/j.nmni.2020.100789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/25/2020] [Accepted: 10/12/2020] [Indexed: 01/12/2023] Open
Abstract
In Ethiopia, only limited data are available regarding the prevalence of enteric bacterial pathogens and enteroparasites in human immunodeficiency virus (HIV) -infected individuals with diarrhoea. Hence, this study aims to assess the prevalence of enteric bacteria and enteroparasites, and also the antibiotic susceptibility patterns of bacteria in them. An institution-based cross-sectional study was performed in HIV patients with diarrhoea, who visited the Anti-Retroviral Therapy Clinic of the Arba Minch General Hospital between 1 March and 31 August 2019. Data pertaining to sociodemographic characteristics and other factors were collected using a structured questionnaire. Stool culture is of utmost importance in the case of HIV-infected individuals with diarrhoea. Stool samples were collected and examined for bacterial and parasitic pathogens following standard procedures. The antibiotic susceptibility test was performed as per the Kirby-Bauer disc diffusion technique. Data were analysed using SPSS software. A total of 180 individuals were included in the stool collection process. The prevalence rates of enteric bacteria and enteroparasites were 8.3% and 36.1%, respectively. Parasitic infections were more frequent than bacterial infections in these HIV-infected individuals; commonly identified enteroparasites were Giardia lamblia (8.9%) and Cryptosporidium parvum (8.3%). Campylobacter sp. was the most predominant enteric bacterial isolate (4.4%), followed by Salmonella (2.1%) and Shigella (1.1%) species. CD4 counts <200 cells/μL was significantly associated with both bacterial infections (adjusted OR 9.55, 95% CI 1.54-59.3, p 0.015) and parasitic infections (adjusted OR 3.53, 95% CI 1.3-17.9, p 0.03). Multidrug resistance was also detected in 100%, 75% and 60% of Shigella, Campylobacter and Salmonella sp., respectively. We found that enteroparasitic infections were more frequent than bacterial infections. Statistical analysis revealed that CD4 T-cell counts <200 cells/μL, quality of drinking water sources, hand washing habits after toilet and the presence of domestic animals were significantly associated with the prevalence of enteric pathogens.
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Affiliation(s)
- A.A. Ayele
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - D. Tadesse
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - A. Manilal
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - T. Yohanes
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - M. Seid
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - M. Shewangizaw Mekuria
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Han M, Xiao S, An W, Sang C, Li H, Ma J, Yang M. Co-infection risk assessment of Giardia and Cryptosporidium with HIV considering synergistic effects and age sensitivity using disability-adjusted life years. WATER RESEARCH 2020; 175:115698. [PMID: 32220670 DOI: 10.1016/j.watres.2020.115698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/29/2020] [Accepted: 03/06/2020] [Indexed: 06/10/2023]
Abstract
Co-infection with multiple pathogens, especially the spread of Giardia and Cryptosporidium in source water among those with immunodeficiency, is common worldwide, which will result in an increase in overall risk. In this study, the quantitative microbial risk assessment model was used to estimate the cumulative risk of co-infection with Giardia and Cryptosporidium promoted by HIV, considering age sensitivity. The sensitivity of population segments with different ages was estimated by the optimization method, based on clinical data of cryptosporidiosis and giardiasis with age structure. The factors of co-infection enhancement were used to quantify HIV synergism with the action of other pathogens. The removal rates of Giardia and Cryptosporidium through water treatment were estimated by a model involving turbidity and particles. The results showed that children (0-4 years) were 17.911-fold more sensitive to infection with Giardia than adults (15-64 years), and that with Cryptosporidium was 10.592-fold. Removal rates of these parasites in water treatment plants in major cities in China were estimated to be 2.03 log10. Considering the HIV-synergistic and age-susceptibility effects, the cumulative risk of exposure to Giardia or Cryptosporidium was about 38.781 × 10-6DALYs (Disability-adjusted life years) per person per year, which was much higher than the reference risk level recommended by the World Health Organization (10-6DALYs). The methodology and results of this study will be useful in better evaluating and reducing the burden due to infection of Giardia and/or Cryptosporidium in China and other countries.
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Affiliation(s)
- Mingyi Han
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Shumin Xiao
- School of Environmental and Municipal Engineering, Tianjin Chengjian University, Tianjin, 300384, China
| | - Wei An
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, 100049, China; Department of Mathematical Sciences, Tsinghua University, 100084, China.
| | - Chenhui Sang
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China; Sino-Danish College, University of Chinese Academy of Sciences, Beijing, 100190, China
| | - Hongyan Li
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Jinfeng Ma
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Min Yang
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, 100049, China.
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Abange WB, Nkenfou CN, Gonsu Kamga H, Nguedia CA, Kamgaing N, Lozupone C, Sosso SM, Kamgaing R, Fosso S, Essomba A, Ndjolo A, Koki P. Intestinal Parasites Infections among HIV Infected Children Under Antiretrovirals Treatment in Yaounde, Cameroon. J Trop Pediatr 2020; 66:178-186. [PMID: 31325361 DOI: 10.1093/tropej/fmz048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Intestinal parasitic infections are among the most common communicable diseases worldwide, particularly in developing countries. Human immunodeficiency virus (HIV) causes dysregulation of the immune system through the depletion of CD4+ T lymphocytes which gives rise to opportunistic infections. METHODOLOGY A cross-sectional study was conducted from January to October 2018. Stool and blood samples were collected from participants aged 1 to 19. Stool samples were analyzed for intestinal parasites. Blood samples were analyzed for HIV and CD4 + T cell counts. RESULTS Out of 214 children enrolled, 119 (55.6%) were HIV infected and 95 (44.4%) were HIV non-infected. All infected children were on antiretroviral treatment (ART). The prevalence of intestinal parasites was 20.2% in HIV infected and 15.8% in non-infected children. Among the 119 HIV infected children, 33 (27.7%) of them had a CD4+ T cell count less than 500 cells/mm3, and amongst them 5.9% had CD4+ T cell count less than 200 cells/mm3. Among HIV infected children, Cryptosporidium spp. was frequently detected, 7/119 (5.9%), followed by Giardia lamblia 5/119 (4.2%) then Blastocystis hominis 3/119 (2.5%) and Entamoeba coli 3/119 (2.5%). Participants on ART and prophylactic co-trimoxazole for >10 years had little or no parasite infestation. CONCLUSIONS Although ART treatment in combination with prophylactic co-trimoxazole reduces the risk of parasitic infection, 20.2% of HIV infected children harbored intestinal parasites including Cryptosporidium spp. Stool analysis may be routinely carried out in order to treat detected cases of opportunistic parasites and such improve more on the life quality of HIV infected children.
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Affiliation(s)
- William Baiye Abange
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, Cameroon.,Medical Microbiology Laboratory, Yaoundé University Teaching Hospital, Cameroon.,Chantal Biya International Center for Research on HIV/AIDS Prevention and Management, Yaounde, Cameroon
| | - Celine Nguefeu Nkenfou
- Chantal Biya International Center for Research on HIV/AIDS Prevention and Management, Yaounde, Cameroon.,Higher Teachers' Training College, University of Yaounde I, Yaounde, Cameroon
| | - Hortense Gonsu Kamga
- Medical Microbiology Laboratory, Yaoundé University Teaching Hospital, Cameroon.,Department of ORL, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
| | - Clement Assob Nguedia
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, Cameroon
| | - Nelly Kamgaing
- Chantal Biya International Center for Research on HIV/AIDS Prevention and Management, Yaounde, Cameroon.,Department of ORL, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
| | - Catherine Lozupone
- Department of Medicine, School of Medicine, University of Colorado, Denver, USA
| | - Samuel Martin Sosso
- Chantal Biya International Center for Research on HIV/AIDS Prevention and Management, Yaounde, Cameroon
| | - Rachel Kamgaing
- Chantal Biya International Center for Research on HIV/AIDS Prevention and Management, Yaounde, Cameroon
| | - Samuel Fosso
- Medical Microbiology Laboratory, Yaoundé University Teaching Hospital, Cameroon
| | - Arthur Essomba
- Medical Microbiology Laboratory, Yaoundé University Teaching Hospital, Cameroon
| | - Alexis Ndjolo
- Chantal Biya International Center for Research on HIV/AIDS Prevention and Management, Yaounde, Cameroon.,Department of ORL, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
| | - Paul Koki
- Department of ORL, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon.,Center for Mother and Child/Chantal Biya's Foundation, Yaounde, Cameroon
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IZADI S, MOHAGHEGH MA, GHAYOUR-NAJAFABADI Z, AZAMI M, MIRZAEI F, NAMDAR F, MOHEBALI M, LESHAN WANNIGAMA D, HEJAZI SH. Frequency and Molecular Identification of Cryptosporidium Species among Immunocompromised Patients Referred to Hospitals, Central Iran, 2015-16. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:31-39. [PMID: 32489373 PMCID: PMC7244833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The purpose of this study was to determine the prevalence and genotype of Cryptosporidium spp. in different groups of immunocompromised patients admitted to the referral hospitals in center of Iran during 2015-2016. METHODS This cross-sectional study was conducted on 346 immunocompromised patients (HIV+/AIDS, Lymphoma, Leukemia and organ transplants) in referred hospitals from central parts of Iran including Isfahan, Markazi, Yazd and Chaharmahale Bakhtiari provinces. Stool samples were analyzed for Cryptosporidium species, modified Ziehl-Neelsen staining techniques followed by the semi-nested PCR and DNA sequencing methods. RESULTS The total rate of Cryptosporidium spp. was 3.46% (12/346) in the patients, however, the prevalence of the parasite, was 4.6% (4/87) in HIV+/AIDS patients, 3.6% (6/168) in patients with blood malignancy and 2.1% (2/91) in organ transplant recipients. The SSU rRNA gene of Cryptosporidium spp. in all microscopic-positive samples was effectively amplified by the semi-nested PCR and DNA sequences, exposed the existence of two Cryptosporidium species, including C. hominis 91.6% (11/12) and C. parvum 8.3% (1/12). CONCLUSION The predominance of C. hominis in the present study may be certifies the importance of anthroponotic transmission of cryptosporidiosis in center of Iran.
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Affiliation(s)
- Shahrokh IZADI
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali MOHAGHEGH
- Department of Laboratory Sciences, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran, Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Zahra GHAYOUR-NAJAFABADI
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi AZAMI
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzaneh MIRZAEI
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Department of Laboratory Sciences, School of Para-Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh NAMDAR
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi MOHEBALI
- Department of Medical Parasitology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| | - Dhammika LESHAN WANNIGAMA
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand, Davison of Pediatrics, School of Medicine, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Seyed-Hossein HEJAZI
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence
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Sweileh WM. A bibliometric analysis of human strongyloidiasis research (1968 to 2017). TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2019; 5:24. [PMID: 31890240 PMCID: PMC6921599 DOI: 10.1186/s40794-019-0100-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/11/2019] [Indexed: 12/05/2022]
Abstract
Background Strongyloidiasis is a neglected tropical disease (NTD). It is commonly associated with poverty and poor hygiene. Strongyloidiasis poses an unseen global public health problem. The aim of this study was to assess and analyze peer-reviewed literature on human strongyloidiasis to shed light on the evolution, volume, important topics, and key players in the field of human strongyloidiasis. Methods A validated bibliometric method was implemented using Scopus database for the study period from 1968 to 2017. The search strategy was developed based on keywords related to strongyloidiasis. Bibliometric indicators and visualization maps were presented. Results In total, 1947 documents were found. Retrieved documents received 32,382 citations, an average of approximately 16.6 per document, and an h-index of 76. The most frequently encountered keywords in the retrieved literature focused on hyperinfection, diagnosis, prevalence, and ivermectin. The USA led with 540 (27.7%) documents followed by Brazil (139; 7.1%) and Japan (137; 7.0%). When research output was standardized by income and population size, India ranked first (12.4 documents per GDP/capita) followed by the USA (9.1 documents per GDP/capita). The most active journal involved in publishing articles was the American Journal of Tropical Medicine and Hygiene (95; 4.8%). In terms of institutions, the University of Ryukyus (Japan) was the most active with 62 (3.2%) publications, followed by the University of Pennsylvania with 54 (2.8%) publications. Conclusion The volume, growth, and international research collaboration in human strongyloidiasis were inadequate given the long history of the disease, the large number of affected people, and the results obtained for other NTDs. Research in human strongyloidiasis needs to be strengthened and encouraged in endemic regions in Southeast Asia and Latin America. International research networking needs to be established to achieve the goals of Sustainable Development Goals in fighting and eradicating NTDs by 2030.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology and Pharmacology/Toxicology, Division of Biomedical Sciences College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Nkengni SMM, Zoumabo ATC, Soppa NPS, Sizono ABN, Vignoles P, Tchuenté LAT, Teukeng FFD. Current decline in schistosome and soil-transmitted helminth infections among school children at Loum, Littoral region, Cameroon. Pan Afr Med J 2019; 33:94. [PMID: 31489072 PMCID: PMC6713490 DOI: 10.11604/pamj.2019.33.94.18265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 05/09/2019] [Indexed: 11/24/2022] Open
Abstract
Introduction Soil-transmitted helminth infections (STHs) and schistosomiasis have serious consequences for the health, education and nutrition of children in developing countries. As Loum is known as a highly endemic commune for these infections, several deworming campaigns have been carried out in the past. The purpose of this study was to determine any changes that have occurred since then in the characteristics of these infections among schoolchildren in this site. Methods A cross-sectional study was conducted in October 2016 on 289 schoolchildren. Stool and urine samples were collected and examined to determine the prevalence and intensity of helminth infections. Results The highest prevalence was noted for Schistosoma haematobium (34.2%), followed by Ascaris lumbricoides (8.6%), S. mansoni (4.9%) and Trichuris trichiura (4.9%) in decreasing order. A prevalence of less than 2% was noted for each of the other two helminths. The highest mean intensity was found for S. haematobium (39.6 eggs/10 ml of urine), followed by A. lumbricoides (24.2 eggs per gram of faeces: epg), Strongyloides stercoralis (16.6 epg) and Schistosoma mansoni (12.3 epg). The prevalence of T. trichiura was significantly higher in boys and that of S. haematobium in children aged 10 years or older, while the differences between other values of prevalence or between egg burdens were not significant. Conclusion Compared with values reported in 2003, the prevalence and intensity of schistosomiases and STH infections in Loum has sharply decreased in 2016. Confirmation of this decrease in the years to come allowed to space deworming campaigns among schoolchildren.
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Affiliation(s)
| | | | - Naomi Paloma Sangue Soppa
- Faculty of Health Sciences, Campus of Banekane, Université des Montagnes, P.O. Box 208, Bangangté, Cameroon
| | - Adèle Besch Ngwem Sizono
- Faculty of Health Sciences, Campus of Banekane, Université des Montagnes, P.O. Box 208, Bangangté, Cameroon
| | - Philippe Vignoles
- INSERM U 1094, Institute of Neuroepidemiology and Tropical Neurology, 2, rue du Docteur Raymond Marcland, 87025 Limoges, France
| | - Louis-Albert Tchuem Tchuenté
- Centre for Schistosomiasis and Parasitology, Texaco Omnisport and Laboratory of Parasitology and Ecology, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon
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Schilling KA, Awuor AO, Rajasingham A, Moke F, Omore R, Amollo M, Farag TH, Nasrin D, Nataro JP, Kotloff KL, Levine MM, Ayers T, Laserson K, Blackstock A, Rothenberg R, Stauber CE, Mintz ED, Breiman RF, O'Reilly CE. Water, Sanitation, and Hygiene Characteristics among HIV-Positive Households Participating in the Global Enteric Multicenter Study in Rural Western Kenya, 2008-2012. Am J Trop Med Hyg 2019; 99:905-915. [PMID: 30084344 DOI: 10.4269/ajtmh.17-0774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Diarrheal illness, a common occurrence among people living with human immunodeficiency virus (PLHIV), is largely preventable through access to safe drinking water quality, sanitation, and hygiene (WASH) facilities. We examined WASH characteristics among households with and without HIV-positive residents enrolled in the Global Enteric Multicenter Study (GEMS) in rural Western Kenya. Using univariable logistic regression, we examined differences between HIV-positive and HIV-negative households in regard to WASH practices. Among HIV-positive households, we explored the relationship between the length of time knowing their HIV status and GEMS enrollment. No statistically significant differences were apparent in the WASH characteristics among HIV-positive and HIV-negative households. However, we found differences in the WASH characteristics among HIV-positive households who were aware of their HIV status ≥ 30 days before enrollment compared with HIV-positive households who found out their status < 30 days before enrollment or thereafter. Significantly more households aware of their HIV-positive status before enrollment reported treating their drinking water (odds ratio [OR] confidence interval [CI]: 2.34 [1.12, 4.86]) and using effective water treatment methods (OR [CI]: 9.6 [3.09, 29.86]), and had better drinking water storage practices. This suggests that within this region of Kenya, HIV programs are effective in promoting the importance of practicing positive WASH-related behaviors among PLHIV.
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Affiliation(s)
- Kathrine A Schilling
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alex O Awuor
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.,Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya
| | - Anu Rajasingham
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Fenny Moke
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.,Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya
| | - Richard Omore
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.,Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya
| | - Manase Amollo
- Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya
| | - Tamer H Farag
- Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland
| | - Dilruba Nasrin
- Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland
| | - James P Nataro
- Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland
| | - Karen L Kotloff
- Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland
| | - Myron M Levine
- Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland.,Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Tracy Ayers
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kayla Laserson
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.,Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya.,Centers for Disease Control and Prevention India, Delhi, India
| | - Anna Blackstock
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Eric D Mintz
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert F Breiman
- Emory Global Health Institute, Emory University, Atlanta, Georgia.,Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.,Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Ciara E O'Reilly
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Hendrickx E, Thomas LF, Dorny P, Bobić B, Braae UC, Devleesschauwer B, Eichenberger RM, Gabriël S, Saratsis A, Torgerson PR, Robertson LJ, Dermauw V. Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in West and Central Africa. Parasit Vectors 2019; 12:324. [PMID: 31248445 PMCID: PMC6598244 DOI: 10.1186/s13071-019-3584-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 06/24/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The zoonotic tapeworm Taenia saginata, although causing only minor discomfort in humans, is responsible for considerable economic losses in the livestock sector due to condemnation or downgrading of infected beef carcasses. An overview of current knowledge on the distribution and prevalence of this parasite in West and Central Africa is lacking. METHODS We conducted a systematic review, collecting information on published and grey literature about T. saginata taeniosis and bovine cysticercosis from 27 countries/territories in West and Central Africa, published between January 1st, 1990 and December 31st, 2017. RESULTS The literature search retrieved 1672 records, of which 51 and 45 were retained for a qualitative and quantitative synthesis, respectively. Non-specified human taeniosis cases were described for Nigeria, Cameroon, Senegal, Burkina Faso, Democratic Republic Congo, Guinea, and Ivory Coast (seven out of 27 countries/territories), while T. saginata taeniosis specifically was only reported for Cameroon. Most prevalence estimates for taeniosis ranged between 0-11%, while three studies from Nigeria reported prevalence estimates ranging between 23-50%. None of the studies included molecular confirmation of the causative species. The presence of bovine cysticercosis was reported for Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Democratic Republic Congo, Ghana, Guinea, Ivory Coast, Mali, Niger, Nigeria, Senegal, and Tristan da Cunha (14 out of 27 countries/territories). Prevalence estimates ranged between 0-29%. CONCLUSIONS Our systematic review has revealed that human taeniosis and bovine cysticercosis are seriously understudied in West and Central Africa. The high prevalence estimates of both conditions suggest an active dissemination of this parasite in the region, calling for a concerted One Health action from public health, veterinary health and food surveillance sectors.
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Affiliation(s)
- Emilie Hendrickx
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lian F. Thomas
- International Livestock Research Institute (ILRI), P.O. Box 30709, Nairobi, Kenya
- Institute for Infection & Global Health, University of Liverpool, Neston, UK
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Branko Bobić
- Centre of Excellence for Food and Vector-borne Zoonoses, Institute for Medical Research, University of Belgrade, Dr Subotića 4, Belgrade, 11000 Serbia
| | - Uffe Christian Braae
- One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, P.O. Box 334, Basseterre, Saint Kitts and Nevis
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, 2300 Copenhagen, Denmark
| | - Brecht Devleesschauwer
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Ramon M. Eichenberger
- Institute of Parasitology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Anastasios Saratsis
- Veterinary Research Institute, Hellenic Agricultural Organisation Demeter, Thermi, 57001 Greece
| | - Paul R. Torgerson
- Institute of Parasitology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Lucy J. Robertson
- Department of Food Safety and Infection Biology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Oslo, Norway
| | - Veronique Dermauw
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Gebrewahid T, Gebrekirstos G, Teweldemedhin M, Gebreyesus H, Awala A, Tadla K. Intestinal parasitosis in relation to CD4 count and anemia among ART initiated patients in St. Mary Aksum general hospital, Tigray, Ethiopia. BMC Infect Dis 2019; 19:350. [PMID: 31029088 PMCID: PMC6486999 DOI: 10.1186/s12879-019-3989-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 04/15/2019] [Indexed: 12/12/2022] Open
Abstract
Background The geographical distribution of intestinal parasites with conditions of poverty in most countries of sub-Saharan Africa coincides with that of HIV/AIDS. However, there is paucity of studies investigating the relationship between intestinal parasitic infections with CD4 counts and anemia in HIV/AIDS patients starting Antiretroviral Therapy (ART) in this region particularly and in Ethiopia in general. The aim of this study was to determine the prevalence of intestinal parasitic infections in relation to CD4 count and anemia among ART-initiated patients in St. Mary Aksum General Hospital, Tigray, Ethiopia. Methods A cross-sectional study was conducted among randomly selected 242 ART-initiated participants during February to April 2017 in St. Mary Aksum General hospital. Data was collected using structured questionnaire and laboratory examination. Logistic regression was applied to assess any association between explanatory factors and outcome variables (P values < 0.05). Result The overall prevalence of intestinal parasites was 26.4% and among the six types of parasitic genera identified Entamoeba histolytica/dispar (18.6%) and Giardia lamblia (2.1%) were the leading. According to the multivariate analysis, lack of hand washing before meal, eating uncooked vegetables, history of taking anti-parasite medication, stool consistency, and anemia were strongly associated with intestinal parasitosis. Conclusion There was a high prevalence of intestinal parasites among HIV positive individuals. Intervention measures such as deworming, improving hygiene and sanitation practices should be strengthened to reduce the burden of intestinal parasites among people living with HIV. Electronic supplementary material The online version of this article (10.1186/s12879-019-3989-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tuom Gebrewahid
- Department of Medical Laboratory Sciences, College of Health Sciences, Aksum University, P.O. Box 298, Aksum, Tigray, Ethiopia
| | - Gebretsadkan Gebrekirstos
- Department of Medical Laboratory Sciences, College of Health Sciences, Aksum University, P.O. Box 298, Aksum, Tigray, Ethiopia
| | - Mebrahtu Teweldemedhin
- Department of Medical Laboratory Sciences, College of Health Sciences, Aksum University, P.O. Box 298, Aksum, Tigray, Ethiopia.
| | - Hailay Gebreyesus
- Department of Public Health, College of Health Sciences, Aksum University, Aksum, Tigray, Ethiopia
| | - Abrham Awala
- Department of Medical Parasitology and Entomology, Institute of Biomedical, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Kiros Tadla
- Department of Medical Parasitology and Entomology, Institute of Biomedical, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
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Intestinal Parasites Associated with Opportunistic Coccidial Infections Among Immunocompromised Individuals in Central Iran: A Cross Sectional Study. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2019. [DOI: 10.5812/archcid.79701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gebretsadik D, Haileslasie H, Feleke DG. Intestinal parasitosis among HIV/AIDS patients who are on anti-retroviral therapy in Kombolcha, North Central, Ethiopia: a cross-sectional study. BMC Res Notes 2018; 11:613. [PMID: 30144820 PMCID: PMC6109261 DOI: 10.1186/s13104-018-3726-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/21/2018] [Indexed: 11/27/2022] Open
Abstract
Objective Human immunodeficiency virus (HIV) infected patients are highly vulnerable to microbial and parasitic diseases due to the immune-suppression. This study aimed to determine the prevalence and assess the associated risk factors of intestinal parasites in HIV/AIDS patients who are under anti-retroviral therapy in Kombolcha, North-Central Ethiopia. Result A total of 223 HIV sero-positive individuals who are on ART in Kombolcha Health Centre were examined for intestinal parasites. Of the total study participants 153 (68.6%) were females, 205 (91.9%) were urban resident and 116 (52.0%) were married. Intestinal parasites were detected in 31 (13.9%) of the 223 study participants. Nine different intestinal parasite species were detected and the most prevalent intestinal parasite detected was E. histolytica, which accounts 7.2% (16/223). Majority of study participants had the habit of washing their hand before meal and after toilet 215 (96.4%) and most of the study participants 126 (56.5%) had private toilet. Electronic supplementary material The online version of this article (10.1186/s13104-018-3726-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniel Gebretsadik
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Haftay Haileslasie
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Daniel Getacher Feleke
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
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Eshetu T, Sibhatu G, Megiso M, Abere A, Baynes HW, Biadgo B, Zeleke AJ. Intestinal Parasitosis and Their Associated Factors among People Living with HIV at University of Gondar Hospital, Northwest-Ethiopia. Ethiop J Health Sci 2018; 27:411-420. [PMID: 29217943 PMCID: PMC5615030 DOI: 10.4314/ejhs.v27i4.12] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Most HIV clients die of AIDS related intestinal parasitic infections rather than due to the HIV infection itself. Therefore, this study was aimed at determining the prevalence of intestinal parasite and their associated factors among HIV/AIDS clients at the University of Gondar Hospital, Northwest Ethiopia. Methods Institution based cross sectional study was conducted using systematic random sampling technique from March to May 2016. A semi-structured questionnaire was used to collect data. Stool samples were collected and processed using direct wet mount, formol-ether concentration and modified Ziehl-Neelson staining techniques. Besides, blood samples were collected for CD4+ count estimation. Both descriptive and logistic regression analyses were used in data analysis. P-values <0.05 were considered as statistically significant. Results A total of 223 participants were enrolled in this study, and the prevalence of intestinal parasitosis was found to be 29.1%. The most predominant intestinal parasite detected was cyst of Entamoeba histolytica (8.5%) followed by Ascaris lumbricoides (6.7%), Strongyloides sterocoralis (3.6%) and Cryptosporidium parvum (3.1%), whereas Schistosoma mansoni (0.9%) and Hymenolepis nana (0.9%) were the least detected. Absence of toilet (AOR= 19.4, CI: 6.46–58.3), improper hand washing before meal (AOR=11.23, 95% CI: 4.16–30.27 and CD4+ count < 200 cells/mm3 (AOR=33.31, 95% CI: 9.159–121.149) had significant association with prevalence of intestinal parasites. Conclusion The study indicated that intestinal parasites are still a problem among HIV/AIDS patients in the study area. Thus, routine examination for intestinal parasites and interventions should be carried out for better management of clients.
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Affiliation(s)
- Tegegne Eshetu
- Department of Quality Assurance, School of Biomedical and Laboratory Sciences, University of Gondar, Ethiopia
| | - Getinet Sibhatu
- Department of Quality Assurance, School of Biomedical and Laboratory Sciences, University of Gondar, Ethiopia
| | - Mohammed Megiso
- Department of Quality Assurance, School of Biomedical and Laboratory Sciences, University of Gondar, Ethiopia
| | - Abrham Abere
- Department of Parasitology, School of Biomedical and Laboratory Sciences, University of Gondar, Ethiopia
| | - Habtamu Wondifraw Baynes
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, University of Gondar, Ethiopia
| | - Belete Biadgo
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, University of Gondar, Ethiopia
| | - Ayalew Jejaw Zeleke
- Department of Parasitology, School of Biomedical and Laboratory Sciences, University of Gondar, Ethiopia
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Amoo JK, Akindele AA, Amoo AOJ, Efunshile AM, Ojurongbe TA, Fayemiwo SA, Thomas BN, Ojurongbe O. Prevalence of enteric parasitic infections among people living with HIV in Abeokuta, Nigeria. Pan Afr Med J 2018; 30:66. [PMID: 30344850 PMCID: PMC6191249 DOI: 10.11604/pamj.2018.30.66.13160] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 02/04/2018] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Enteric 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. METHODS Freshly 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 technique. RESULTS A 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. 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.
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Affiliation(s)
- John Kehinde Amoo
- Department of Medical Microbiology & Parasitology, Olabisi Onabanjo University, Ago-Iwoye, Nigeria
| | - Akeem Abiodun Akindele
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Osogbo, Nigeria
| | | | - Akinwale Michael Efunshile
- Department of Medical Microbiology & Parasitology, Olabisi Onabanjo University, Ago-Iwoye, Nigeria
- Department of Medical Microbiology, Ebonyi State University, Abakaliki, Nigeria
| | | | - Samuel Adetona Fayemiwo
- Department of Medical Microbiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Bolaji Nun Thomas
- Department of Biomedical Sciences, College of Health Sciences and Technology, Rochester Institute of Technology, Rochester NY, USA
| | - Olusola Ojurongbe
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Osogbo, Nigeria
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Rich SN. RE: Intestinal Parasitic Infections in Human Immunodeficiency Virus-Infected and Noninfected Persons in a High Human Immunodeficiency Virus Prevalence Region of Cameroon. Am J Trop Med Hyg 2018; 98:633. [PMID: 29415792 PMCID: PMC5929215 DOI: 10.4269/ajtmh.17-0859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Nkenfou CN, Tchameni SM, Nkenfou CN, Djataou P, Simo UF, Nkoum AB, Estrin W. Intestinal Parasitic Infections in Human Immunodeficiency Virus-Infected and Noninfected Persons in a High Human Immunodeficiency Virus Prevalence Region of Cameroon. Am J Trop Med Hyg 2017; 97:777-781. [PMID: 28722574 PMCID: PMC5590583 DOI: 10.4269/ajtmh.16-0900] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/14/2017] [Indexed: 11/07/2022] Open
Abstract
The problem of intestinal parasitic infection in human immunodeficiency virus (HIV)-infected people requires careful consideration in the developing world where poor nutrition is associated with poor hygiene and several coinfecting diseases. Studies have addressed this issue in Cameroon, especially in the low HIV prevalence area. The current study was conducted to determine the prevalence of intestinal parasitosis in people living with HIV (PLHIV) in Adamaoua and to identify associated risk factors. Stool and blood specimens from study participants were screened for intestinal parasites and anti-HIV antibodies, respectively. Of 235 participants, 68 (28.9%) were HIV positive, 38 of them on antiretroviral treatment (ART). The overall prevalence of intestinal parasites was 32.3%. Of 68 PLHIV, 32.3% (22/68) were infected with intestinal parasites, compared with 32.3% (54/167) of the HIV-negative patients. Univariate analysis showed no difference between the prevalence of intestinal parasites among PLHIV and HIV-negative patients (P = 0.69). ART was not associated with the prevalence of intestinal parasites. Multivariate analysis showed that the quality of water and the personal hygiene were the major risk factors associated to intestinal parasitosis. The level of education was associated with HIV serostatus: the higher the level of education, the lower the risk of being infected with HIV (P = 0.00). PLHIV and the general population should be screened routinely for intestinal parasites and treated if infected.
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Affiliation(s)
- Céline Nguefeu Nkenfou
- Laboratory of Systems Biology, “Chantal Biya” International Reference Centre for Research on HIV/AIDS Prevention and Management (CBIRC), Yaounde, Cameroon
- Department of Biological Sciences, Higher Teacher Training College, University of Yaounde I, Yaounde, Cameroon
- Molecular Biology Center, Yaounde, Cameroon
| | | | | | - Patrice Djataou
- Molecular Biology Center, Yaounde, Cameroon
- Faculty of Sciences, University of Yaounde I, Yaounde, Cameroon
| | | | | | - William Estrin
- California Pacific Medical Center, San Francisco, California
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Faria CP, Zanini GM, Dias GS, Sousa MDC. Associations of Giardia lamblia assemblages with HIV infections and symptomatology: HIV virus and assemblage B were they born to each other? Acta Trop 2017; 172:80-85. [PMID: 28456597 DOI: 10.1016/j.actatropica.2017.04.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 04/20/2017] [Accepted: 04/22/2017] [Indexed: 12/13/2022]
Abstract
Giardia lamblia is an intestinal parasite that has an extensive genetic variation among isolates. This species is divided into eight different assemblages (A-H), but only assemblages A and B have been associated with human infections. Studies on the associations of G. lamblia assemblages and symptoms have been done but were inconclusive. The aim of this study was to correlate G. lamblia assemblages with symptoms in patients with and without HIV/AIDS and its association with the CD4T cell count. The cross-sectional survey was conducted among patients attending the Evandro Chagas National Institute of Infectious Diseases (INI/FIOCRUZ) in Rio de Janeiro from January 2011 to February 2015. Thirty-eight of 65 microscopically positive stool samples for G. lamblia were from HIV positive patients and 27 were from HIV negative patients. Of the HIV infected patients, 19 (55.9%) were genotyped as assemblage B of which 9 (47.4%) had a CD4Tcell count below 200cells/mm3. In addition, we found a greater number of samples belonging to assemblage B in symptomatic cases (11 of 19; 57.9%). Our data suggest that assemblage B is very likely to be found in HIV infected patients and probably the lower CD4T count gives advantages for assemblage B replication. Furthermore, assemblage B seems to be associated with symptomatology, particularly abdominal pain, asthenia, diarrhea, fever, headache and myalgia. This study provides information on G. lamblia assemblages and symptoms in patients with and without HIV/AIDS virus and their association with CD4Tcell counts.
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Affiliation(s)
- Clarissa Perez Faria
- CNC - Center for Neurosciences and Cell Biology, University of Coimbra, 3030-548 Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, 3030-548 Coimbra, Portugal; Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil
| | - Graziela Maria Zanini
- Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil
| | - Gisele Silva Dias
- Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil
| | - Maria do Céu Sousa
- CNC - Center for Neurosciences and Cell Biology, University of Coimbra, 3030-548 Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, 3030-548 Coimbra, Portugal.
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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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Squire SA, Ryan U. Cryptosporidium and Giardia in Africa: current and future challenges. Parasit Vectors 2017; 10:195. [PMID: 28427454 PMCID: PMC5397716 DOI: 10.1186/s13071-017-2111-y] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/24/2017] [Indexed: 12/15/2022] Open
Abstract
Cryptosporidium and Giardia are important causes of diarrhoeal illness. Adequate knowledge of the molecular diversity and geographical distribution of these parasites and the environmental and climatic variables that influence their prevalence is important for effective control of infection in at-risk populations, yet relatively little is known about the epidemiology of these parasites in Africa. Cryptosporidium is associated with moderate to severe diarrhoea and increased mortality in African countries and both parasites negatively affect child growth and development. Malnutrition and HIV status are also important contributors to the prevalence of Cryptosporidium and Giardia in African countries. Molecular typing of both parasites in humans, domestic animals and wildlife to date indicates a complex picture of both anthroponotic, zoonotic and spill-back transmission cycles that requires further investigation. For Cryptosporidium, the only available drug (nitazoxanide) is ineffective in HIV and malnourished individuals and therefore more effective drugs are a high priority. Several classes of drugs with good efficacy exist for Giardia, but dosing regimens are suboptimal and emerging resistance threatens clinical utility. Climate change and population growth are also predicted to increase both malnutrition and the prevalence of these parasites in water sources. Dedicated and co-ordinated commitments from African governments involving "One Health" initiatives with multidisciplinary teams of veterinarians, medical workers, relevant government authorities, and public health specialists working together are essential to control and prevent the burden of disease caused by these parasites.
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Affiliation(s)
- Sylvia Afriyie Squire
- School of Veterinary and Life Sciences, Murdoch University, Perth, Australia
- Council for Scientific and Industrial Research, Animal Research Institute, Accra, Ghana
| | - Una Ryan
- School of Veterinary and Life Sciences, Murdoch University, Perth, Australia
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Campbell SJ, Stothard JR, O'Halloran F, Sankey D, Durant T, Ombede DE, Chuinteu GD, Webster BL, Cunningham L, LaCourse EJ, Tchuem-Tchuenté LA. Urogenital schistosomiasis and soil-transmitted helminthiasis (STH) in Cameroon: An epidemiological update at Barombi Mbo and Barombi Kotto crater lakes assessing prospects for intensified control interventions. Infect Dis Poverty 2017; 6:49. [PMID: 28238285 PMCID: PMC5327519 DOI: 10.1186/s40249-017-0264-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/17/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The crater lakes of Barombi Mbo and Barombi Kotto are well-known transmission foci of schistosomiasis and soil-transmitted helminthiasis having had several important control initiatives previously. To collect contemporary epidemiological information, a cross-sectional survey was undertaken inclusive of: signs and symptoms of disease, individual treatment histories, local water, sanitation and hygiene (WASH)-related factors and malacological surveillance, with molecular characterisation of specimens. METHODS At each lake, a community cross-sectional survey was undertaken using a combination of stool and urine parasitological sampling, and interview with pro-forma questionnaires. A total of 338 children and adults participated. Material from snail and parasite species were characterised by DNA methods. RESULTS Egg-patent prevalence of urogenital schistosomiasis was 8.7% at Barombi Mbo (all light-intensity infections) and 40.1% at Barombi Kotto (21.2% heavy-intensity infections). Intestinal schistosomiasis was absent. At Barombi Kotto, significantly more women reported signs and symptoms associated with female genital schistosomiasis. While there had been extensive recent improvement in WASH-related infrastructure at Barombi Mbo, water contact risk scores were higher among schistosomiasis-infected participants (P < 0.001) and at Barombi Kotto in general (P < 0.001). Across both lakes, mean prevalence of STH was very low (6.3%) evidencing an impressive decrease of 79.0% over the last decade; neither Strongyloides stercoralis nor Ascaris lumbricoides were found. A total of 29 freshwater sampling sites were inspected for snails, 13 in Barombi Mbo and 16 in Barombi Kotto; water chemistry differed significantly (P < 0.0001) between lakes for both mean pH (7.9 v. 9.6) and mean conductivity (64.3 μS v. 202.1 μS) respectively. Only two Bulinus camerunensis found on the central island of Barombi Kotto were observed to shed schistosome cercariae, but schistosome DNA was later detected in Bulinus sampled from both lakes as well as in Indoplanorbis exustus, an invasive species from Asia. CONCLUSIONS STH is currently at very low levels while urogenital schistosomiasis is of greatest concern at Barombi Kotto. This assessment highlights a unique opportunity for further study of the epidemiological dynamics at these crater lakes, to evaluate future intensified interventions both in terms of gaining and sustaining control at Barombi Kotto or in moving towards local interruption of transmission of both diseases at Barombi Mbo.
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Affiliation(s)
- Suzy J Campbell
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Faye O'Halloran
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Deborah Sankey
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Timothy Durant
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | | | | | - Bonnie L Webster
- Department of Life Sciences, Parasites and Vectors Division, Natural History Museum, London, SW7 5BD, UK
- London Centre for Neglected Tropical Disease Research, London, UK
| | - Lucas Cunningham
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - E James LaCourse
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Louis-Albert Tchuem-Tchuenté
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
- Laboratory of Parasitology and Ecology, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon
- National Programme for the Control of Schistosomiasis and Intestinal Helminthiasis, Ministry of Public Health, Yaoundé, Cameroon
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Shah S, Kongre V, Kumar V, Bharadwaj R. A Study of Parasitic and Bacterial Pathogens Associated with Diarrhea in HIV-Positive Patients. Cureus 2016; 8:e807. [PMID: 27795876 PMCID: PMC5083165 DOI: 10.7759/cureus.807] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Diarrhea is a common complication of acquired immune deficiency syndrome (AIDS), occurring in almost 90% of AIDS patients in developing countries like India. The present study was aimed to determine the prevalence and microbiological profile of pathogens associated with diarrhea in human immunodeficiency virus (HIV) positive patients and their relation to CD4 counts. MATERIALS AND METHODS Forty-five successive HIV-positive patients, 27 with diarrhea (study group) and 18 without diarrhea (control group), were included in the three-month study. The HIV infection was confirmed by three different antibody detection tests. The stool samples were collected on two consecutive days and were examined for parasites by microscopy using wet mount and modified Ziehl-Neelsen stain. They were examined for bacteria by Gram stain and conventional Ziehl-Neelsen stain and were inoculated on appropriate culture media. The isolates were identified by standard biochemical tests, followed by antibiotic susceptibility testing using the Kirby-Bauer disc diffusion method. RESULTS Twenty-four pathogens were detected in diarrheal HIV-positive patients, including 14 parasites (58.33%), seven bacteria (29.17%), and three fungi (12.50%). Isospora sp. was the most common parasite (25.9%) followed by Cryptosporidium sp. (14.8%). Other parasites included Cyclospora sp., Strongyloides stercoralis, and Entamoeba histolytica (3.7% each). Escherichia coli (18.5%) was the most common bacterial isolate, of which, 80% were Enterotoxigenic E. coli (ETEC) while 20% were Enteropathogenic E. coli (EPEC). Other isolates included Shigella flexneri and Mycobacterium tuberculosis (3.7% each). The isolates were sensitive to furazolidone (94.11%), chloramphenicol (76.47%), and gentamicin (52.94%). The isolates from diarrheal patients showed resistance to norfloxacin (5.88% vs. 50%, p<0.05) as compared to those from non-diarrheal patients. The diarrheal HIV-positive patients had lower mean CD4 counts (202.6 cells/µL), as compared to those without diarrhea (239.28 cells/µL). CONCLUSION Isospora sp. is the most common parasite and Escherichia coli is the most common bacterium associated with diarrhea in HIV patients. The antibiotic sensitivity patterns should be monitored regularly to detect resistance to commonly used drugs. The prevalence of organisms in a region, various clinical manifestations, sensitivity patterns of isolates, and relation with CD4 count should be considered while instituting therapy in HIV patients with diarrhea.
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Affiliation(s)
- Siddharth Shah
- Department of Orthopaedics, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai
| | - Vaishali Kongre
- Department of Microbiology, B. J. Government Medical College & Sassoon General Hospitals, Pune
| | - Varun Kumar
- Department of Medicine, Shri Balaji Action Medical Institute
| | - Renu Bharadwaj
- Department of Microbiology, B. J. Government Medical College & Sassoon General Hospitals, Pune
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Enteric parasitic infection among HIV-infected patients visiting Tribhuvan University Teaching Hospital, Nepal. BMC Res Notes 2016; 9:204. [PMID: 27048153 PMCID: PMC4822322 DOI: 10.1186/s13104-016-2007-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 03/23/2016] [Indexed: 12/03/2022] Open
Abstract
Background Enteric parasitic infection among human immunodeficiency virus (HIV) patients has been a significant health problem in developing countries like Nepal. This study was undertaken to access the burden of enteric parasites among HIV patients and its association with their immune status. Methods A cross-sectional study, involving 112 HIV sero-positive patients was conducted in Tribhuvan University Teaching Hospital, Public Health Research Laboratory, Kathmandu, Nepal from July 2011 to June 2012. The fecal samples were processed by direct-smear technique, in both normal saline solution and 1 % iodine solution as well as modified acid fast staining (Kinyoun’s method) after formalin ether concentration and Sheather’s sucrose flotation for the identification of enteric parasites. Results Infection with one or more parasite was seen in 33.9 % (n = 38) of the cases enrolled in the study, with the parasite prevalence rate of 41.1 % (n = 46). Literacy (OR = 1.9, 95 % CI 0.9–4.3) and CD4 T-cell count <200 (OR = 2.5, 95 % CI 1.1–5.7) were found to be associated with enteric parasite infection. Similarly, CD4 T-cell count <200 was found to be associated with opportunistic parasitic infection (OR = 3.2, 95 % CI 1.2–7.8). Among opportunistic parasites, Giardia duodenalis was the most common (28.3 %, n = 13) one. Multi-parasitism was observed in six patients (15.8 %). Conclusion Enteric parasitic infections are common in HIV-infected people. The poor immune status as indicated by low CD4 T-cell count may account for higher risk of both opportunistic and non-opportunistic enteric parasitic infection.
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Khalil S, Mirdha BR, Sinha S, Panda A, Singh Y, Joseph A, Deb M. Intestinal Parasitosis in Relation to Anti-Retroviral Therapy, CD4(+) T-cell Count and Diarrhea in HIV Patients. THE KOREAN JOURNAL OF PARASITOLOGY 2015; 53:705-12. [PMID: 26797437 PMCID: PMC4725235 DOI: 10.3347/kjp.2015.53.6.705] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 09/03/2015] [Accepted: 09/09/2015] [Indexed: 01/10/2023]
Abstract
Intestinal parasitic infections are one of the major causes of diarrhea in human immunodeficiency virus (HIV) seropositive individuals. Antiretroviral therapy has markedly reduced the incidence of many opportunistic infections, but parasite-related diarrhea still remains frequent and often underestimated especially in developing countries. The present hospital-based study was conducted to determine the spectrum of intestinal parasitosis in adult HIV/AIDS (acquired immunodeficiency syndrome) patients with or without diarrhea with the levels of CD4+ T-cell counts. A total of 400 individuals were enrolled and were screened for intestinal parasitosis. Of these study population, 200 were HIV seropositives, and the remaining 200 were HIV uninfected individuals with or without diarrhea. Intestinal parasites were identified by using microscopy as well as PCR assay. A total of 130 (32.5%) out of 400 patients were positive for any kinds of intestinal parasites. The cumulative number of parasite positive patients was 152 due to multiple infections. A significant association of Cryptosporidium (P<0.001) was detected among individuals with CD4+ T-cell counts less than 200 cells/μl.
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Affiliation(s)
- Shehla Khalil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Bijay Ranjan Mirdha
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Sinha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ashutosh Panda
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Yogita Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Anju Joseph
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Manorama Deb
- Department of Microbiology, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Nath J, Ghosh SK, Singha B, Paul J. Molecular Epidemiology of Amoebiasis: A Cross-Sectional Study among North East Indian Population. PLoS Negl Trop Dis 2015; 9:e0004225. [PMID: 26633890 PMCID: PMC4669114 DOI: 10.1371/journal.pntd.0004225] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 10/21/2015] [Indexed: 12/30/2022] Open
Abstract
Background Epidemiological studies carried out using culture or microscopy in most of the amoebiasis endemic developing countries, yielded confusing results since none of these could differentiate the pathogenic Entamoeba histolytica from the non-pathogenic Entamoeba dispar and Entamoeba moshkovskii. The Northeastern part of India is a hot spot of infection since the climatic conditions are most conducive for the infection and so far no systemic study has been carried out in this region. Methodology/Principal Findings Following a cross-sectional study designed during the period 2011–2014, a total of 1260 fecal samples collected from the Northeast Indian population were subjected to microscopy, fecal culture and a sensitive and specific DNA dot blot screening assay developed in our laboratory targeting the Entamoeba spp. Further species discrimination using PCR assay performed in microscopy, culture and DNA dot blot screening positive samples showed E. histolytica an overall prevalence rate of 11.1%, 8.0% and 13.7% respectively. In addition, infection rates of nonpathogenic E. dispar and E. moshkovskii were 11.8% (95% CI = 10.2, 13.8) and 7.8% (95% CI = 6.4, 9.4) respectively. The spatial distributions of infection were 18.2% (107/588) of Assam, 11.7% (23/197) of Manipur, 10.2% (21/207) of Meghalaya, and 8.2% (22/268) of Tripura states. Association study of the disease with demographic features suggested poor living condition (OR = 3.21; 95% CI = 1.83, 5.63), previous history of infection in family member (OR = 3.18; 95% CI = 2.09, 4.82) and unhygienic toilet facility (OR = 1.79; 95% CI = 1.28, 2.49) as significant risk factors for amoebiasis. Children in age group <15 yr, participants having lower levels of education, and daily laborers exhibited a higher infection rate. Conclusions/Significance Despite the importance of molecular diagnosis of amoebiasis, molecular epidemiological data based on a large sample size from endemic countries are rarely reported in the literature. Improved and faster method of diagnosis employed here to dissect out the pathogenic from the nonpathogenic species would help the clinicians to prescribe the appropriate anti-amoebic drug. Most epidemiologic studies in developing countries carried out for amoebiasis is either based on microscopy alone or culture/ microscopy used as a screening tool, have poor sensitivity and specificity and thus fails to figure out its true magnitude. The purpose of this study was to assess the true prevalence of amoebiasis in selected North Eastern states of India using DNA based screening technique followed by PCR assay for species discrimination. In addition, PCR assay confirmed that only 55.8% of the samples, resembling E. histolytica by microscopy, were true E. histolytica, implying that remaining 44.2% of so-called infections were due to other nonpathogenic Entamoeba spp. We found a higher prevalence of amebiasis (13.7%) using DNA dot blot screening compared to conventional microscopy and culture based screening. Poor living condition, previous history of infection in a family member, unhygienic toilet facility, children in age group <15 yr, participants having lower levels of education and daily laborers were identified as significant risk factors for amoebiasis. Thus, the techniques like DNA dot blot hybridization and PCR based detection adopted in the present study over and above the conventional screening methods can reduce misdiagnosis of the disease appreciably from the population living in this endemic area.
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Affiliation(s)
- Joyobrato Nath
- Department of Zoology, Gurucharan College, Silchar, Assam, India
- Department of Biotechnology, Assam University, Silchar, Assam, India
| | | | - Baby Singha
- Department of Zoology, Gurucharan College, Silchar, Assam, India
| | - Jaishree Paul
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
- * E-mail:
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Oyedeji OA, Adejuyigbe E, Oninla SO, Akindele AA, Adedokun SA, Agelebe E. Intestinal Parasitoses in HIV Infected Children in a Nigerian Tertiary Hospital. J Clin Diagn Res 2015; 9:SC01-5. [PMID: 26673562 DOI: 10.7860/jcdr/2015/12537.6736] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 05/07/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Intestinal parasitoses are common amongst people living in developing countries. They may impact negatively on the growth and health of immune competent children. There is paucity of information on the association between HIV and intestinal parasitoses in African children. OBJECTIVE To identify the intestinal infections responsible for infections in HIV infected children and document characteristics of HIV infected children at a Nigerian teaching hospital. MATERIALS AND METHODS Consecutive children attending a Paediatric anti-retroviral clinic were studied. Information such as socio-demographics and clinical characteristics elicited from clinical examination were recorded in the proforma. Stool samples of the children were obtained and examined for intestinal parasites. Data was analysed with the SPSS 18 software. RESULTS A total 52 children were studied and their age ranged between 6 months and 14 years, with a mean of 6.5 years ± 3.93. The 52 were made up of 27 boys and 25 girls, giving a male: female ratio of 1.1:1. 10 (19.2%) of the 52 children were infected with cryptosporidium spp, while 1(1.9%) had Ascaris lumbricoides infestation. Anti-helminthics had previously been administered to 86.5% of children studied. Those who previously received anti-helminthics had lower prevalence estimates of cryptosporidium infections. (p<0.01, RR = 0.42, 95%CI = 0.20 - 0.90). Children on co-trimoxazole prophylaxis had lower prevalence estimates of cryptosporidium infections. (P<0.01, RR = 0.35, 95%CI = 0.14 - 0.91). Use of highly active antiretroviral drugs was also associated with lower prevalence estimates of intestinal cryptosporidium. (p=0.04, RR = 0.58, 95%CI = 0.31 - 1.10). Eight of the 10 children infected with cryptosporidium had recurrent abdominal pain in comparison with the six with recurrent abdominal pain amongst the 42 without cryptosporidial infections. (p<0.01, RR=5.6, 95%CI= 2.51 - 12.1). CONCLUSION Cryptosporidial infection is the most common intestinal parasitoses among HIV infected children in this study, while intestinal helminthiasis are not so common. Anti-helminthics, Co-trimoxazole prophylaxis and highly active anti-retroviral therapy have a protective effect against intestinal cryptosporidium. Screening for intestinal cryptosporidium is suggested in HIV infected children with recurrent abdominal pain, because of the statistically association.
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Affiliation(s)
- Olusola Adetunji Oyedeji
- Consultant Paediatrician, Department of Paediatrics, LAUTECH Teaching Hospital , Osogbo, Osun State, Nigeria
| | - Ebun Adejuyigbe
- Professor and Consultant Paediatrician, Department of paediatrics, Obafemi Awolowo University Teaching Hospitals , Compkex, Ile - Ife Osun State, Nigeria
| | - Samuel Olorunyomi Oninla
- Consultant Paediatrician, Department of Paediatrics, LAUTECH Teaching Hospital , Osogbo, Osun State, Nigeria
| | - Abiodum Akeem Akindele
- Biomedical Scientist, Department of Community Medicine, College of Health Sciences , Osogbo , Osun State, Nigeria
| | - Samuel Adeyinka Adedokun
- Biomedical Scientist, Department of Community Medicine, College of Health Sciences Osogbo, Osun State, Nigeria
| | - Efeturi Agelebe
- Senior Registrar, Department of Paediatrics, LAUTECH Teaching Hospital , Osogbo, Osun State, Nigeria
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The impact of water, sanitation, and hygiene interventions on the health and well-being of people living with HIV: a systematic review. J Acquir Immune Defic Syndr 2015; 68 Suppl 3:S318-30. [PMID: 25768871 DOI: 10.1097/qai.0000000000000487] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Access to improved water supply and sanitation is poor in low-income and middle-income countries. Persons living with HIV/AIDS (PLHIV) experience more severe diarrhea, hospitalizations, and deaths from diarrhea because of waterborne pathogens than immunocompetent populations, even when on antiretroviral therapy (ART). METHODS We examined the existing literature on the impact of water, sanitation, and hygiene (WASH) interventions on PLHIV for these outcomes: (1) mortality, (2) morbidity, (3) retention in HIV care, (4) quality of life, and (5) prevention of ongoing HIV transmission. Cost-effectiveness was also assessed. Relevant abstracts and articles were gathered, reviewed, and prioritized by thematic outcomes of interest. Articles meeting inclusion criteria were summarized in a grid for comparison. RESULTS We reviewed 3355 citations, evaluated 132 abstracts, and read 33 articles. The majority of the 16 included articles focused on morbidity, with less emphasis on mortality. Contaminated water, lack of sanitation, and poor hygienic practices in homes of PLHIV increase the risk of diarrhea, which can result in increased viral load, decreased CD4 counts, and reduced absorption of nutrients and antiretroviral medication. We found WASH programming, particularly water supply, household water treatment, and hygiene interventions, reduced morbidity. Data were inconclusive on mortality. Research gaps remain in retention in care, quality of life, and prevention of ongoing HIV transmission. Compared with the standard threshold of 3 times GDP per capita, WASH interventions were cost-effective, particularly when incorporated into complementary programs. CONCLUSIONS Although research is required to address behavioral aspects, evidence supports that WASH programming is beneficial for PLHIV.
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Omrani VF, Fallahi S, Rostami A, Siyadatpanah A, Barzgarpour G, Mehravar S, Memari F, Hajialiani F, Joneidi Z. Prevalence of intestinal parasite infections and associated clinical symptoms among patients with end-stage renal disease undergoing hemodialysis. Infection 2015; 43:537-44. [PMID: 25869822 DOI: 10.1007/s15010-015-0778-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 04/05/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Intestinal parasitic infections (IPIs) can result in high morbidity and mortality, particularly in immunocompromised patients. Infectious diseases are among the main causes of death in end-stage renal disease (ESRD) patients due to their impaired immune systems. The aim of this study was to determine the prevalence IPIs and their associated symptoms in ESRD patients. METHODS In this case-control study, the fecal samples of 78 ESRD patients undergoing hemodialysis and 140 controls without any kidney problems were analyzed for intestinal parasites using direct-smear, formol-ether and modified Ziehl-Neelsen staining techniques. RESULTS The difference in the prevalence of IPIs between ESRD patients (30.7 %) and the control group (10.7 %) was significant (OR = 3.7; 95 % CI = 1.8-7.61; P < 0.001). Blastocystis (14.1 %) and Cryptosporidium spp.(11.5 %) were the most common IPIs detected in ESRD patients, and the presence of Cryptosporidium spp. was significantly associated with diarrhea in ESRD patients (OR = 16; 95 % CI = 1.54-166.05; P < 0.05). Leukocytosis, diarrhea, weight loss, nausea/vomiting and bloating were also significantly higher in the hemodialysis group when compared with the control group. CONCLUSION The current study revealed a high prevalence of intestinal parasites and related clinical symptoms in ESRD patients undergoing hemodialysis. Since hemodialysis patients are immunocompromised and intestinal parasites can cause serious clinical complications, we suggest that stool examination for intestinal parasites, with an emphasis on detection of Cryptosporidium spp. and Blastocystis, should be incorporated into the routine clinical care for these patients. Measures for preventing the acquisition of IPIs are also recommended.
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Affiliation(s)
- V Fallah Omrani
- Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Biotechnology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sh Fallahi
- Department of Parasitology and Mycology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - A Rostami
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - A Siyadatpanah
- Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Gh Barzgarpour
- 29-Bahman Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - S Mehravar
- Department of Epidemiology and Statistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - F Memari
- Department of Biotechnology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - F Hajialiani
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Z Joneidi
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Toledo R, Muñoz-Antoli C, Esteban JG. Strongyloidiasis with emphasis on human infections and its different clinical forms. ADVANCES IN PARASITOLOGY 2015; 88:165-241. [PMID: 25911368 DOI: 10.1016/bs.apar.2015.02.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Strongyloidiasis (caused by Strongyloides stercoralis, and to a lesser extent by Strongyloides fuelleborni) is one of the most neglected tropical diseases with endemic areas and affecting more than 100 million people worldwide. Chronic infections in endemic areas can be maintained for decades through the autoinfective cycle with the L3 filariform larvae. In these endemic areas, misdiagnosis, inadequate treatment and the facilitation of the hyperinfection syndrome by immunosuppression are frequent and contribute to a high mortality rate. Despite the serious health impact of strongyloidiasis, it is a neglected disease and very little is known about this parasite and the disease when compared to other helminth infections. Control of the disease is difficult because of the many gaps in our knowledge of strongyloidiasis. We examine the recent literature on different aspects of strongyloidiasis with emphasis in those aspects that need further research.
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Affiliation(s)
- Rafael Toledo
- Departamento de Parasitología, Universidad de Valencia, Valencia, Spain
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Vouking MZ, Enoka P, Tamo CV, Tadenfok CN. Prevalence of intestinal parasites among HIV patients at the Yaoundé Central Hospital, Cameroon. Pan Afr Med J 2014; 18:136. [PMID: 25419274 PMCID: PMC4236773 DOI: 10.11604/pamj.2014.18.136.3052] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 01/30/2014] [Indexed: 12/30/2022] Open
Abstract
Introduction Intestinal parasites are more common in people with HIV, especially in tropical developing countries. This cross-sectional study was carried out to assess the prevalence of intestinal parasites among people with HIV at the Yaoundé Central Hospital Accredited Treatment Centre. Methods Structured questionnaires were used to collect clinical information after obtaining consent from the participants. Stool samples were collected from 207 HIV-positive patients for the investigation of intestinal pathogens using direct microscopy, formalin-ether concentration, ZiehlNeelsen modified and Kato-Katz methods. Data was analyzed using Epi-info version 3.4.1. and Microsoft Office Excel 2007. Results A total of 207 people were recruited. Eighty (38.65%) were male and 127 (61.35%) were female. The overall prevalence of intestinal parasite infections was 57.48% (119/207). The parasites detected in our study population included Entamoeba coli (22.68%), Ascaris lumbricoïdes (22.68%), Entamoeba histolytica(15.93%), Cryptosporidium spp (12.60%), Isospora belli (10.08%), Trichuris trichiura (7.60%), Strongyloïdesstercoralis (5.88%), Ancylostomaduodenale and Necatoramericanus (2.52%). Conclusion At the end of our study, it appears that intestinal parasites still occupy an important place among HIV-positive patients.
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Affiliation(s)
- Marius Zambou Vouking
- Center for the Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon ; Centre Regional Delegation, Ministry of Public Health, Yaoundé, Cameroon
| | - Patrice Enoka
- 'Ecole des Techniciens Médico-Sanitaires de Yaoundé', Cameroon
| | - Claire Violette Tamo
- Center for the Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon
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Systematic detection and association of Entamoeba species in stool samples from selected sites in India. Epidemiol Infect 2014; 143:108-19. [PMID: 24703238 DOI: 10.1017/s0950268814000715] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This study developed a fast and high throughput dot-blot technique to evaluate the presence of Entamoeba in stool samples (n = 643) followed by a PCR-based method to validate and differentiate the two species E. histolytica and E. dispar. The prevalence rate of the parasite has been detected in a cross-sectional study carried out in the population of the Eastern and Northern parts of India. Of the various demographic features, prevalence was highest in the monsoon season (P = 0·017), in the <15 years age group (P = 0·015). In HIV-positive individuals, the prevalence rate was significantly high (P = 0·008) in patients with a CD4 cell count <200 as well as in patients without antiretroviral therapy (ART) (P = 0·011). Our analysis further confirmed that risk factors such as toilet facilities, living conditions, hygienic practices, drinking water source, occupation and level of education are important predictors as they were found to contribute significantly in the prevalence of the parasite.
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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. Parasitol Int 2014; 63:550-6. [PMID: 24603288 DOI: 10.1016/j.parint.2014.02.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 02/22/2014] [Accepted: 02/24/2014] [Indexed: 11/21/2022]
Abstract
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/mm(3). 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.
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