Prevalence and Predisposing Factors of Intestinal Parasitic Infections Among HIV Positive Patients Visiting Nekemte Specialized Hospital, Western Ethiopia

Magnitude of intestinal parasitic infections and its determinants among HIV/AIDS patients attending at antiretroviral treatment centers in East and West Gojam Zones, Northwest, Ethiopia: institution based cross-sectional study

BACKGROUND

Intestinal parasitic infections (IP) are a major source of morbidity in people living with Human immunodeficiency virus (HIV), particularly in resource-limited settings, mostly as a result of high viral load. Hence, this study aimed to investigate the magnitude of intestinal parasitic infections and its determinants among patients with HIV/AIDS attending public health facilities in East and West Gojam Zones in Ethiopia.

METHODS

Institution-based cross-sectional study was conducted on 327 people living with HIV visiting public health facilities from December 2022 to May 2023. A simple random sampling technique was used to recruit participants. Face-to-face interviews were used to collect socio-demographics and determinants. The fresh stool was collected from each patient, transported, and tested in accordance with laboratory standard operating procedures of wet mount, formol-ether concentration technique, and modified acid-fast staining. Data were entered and analyzed in the statistical package for Social Science (SPSS) version 20. A 95% CI with p-value < 0.05 was considered statistically significant.

RESULTS

The overall prevalence of IP in patients with HIV/AIDS was 19.3% (63/327). Hookworm was the most identified parasite 33.3% (21/63) followed by E.histolytica 17% (11/63) and G.lamblia 14.3% (9/63). Parasitic infections were significantly higher among viral load > 1000cps/ml (p = 0.035), WHO stage 4 (p = 0.002), CD4 < 200 cell/mm3 (p = 0.001), and bare foot walking (p = 0.001).

CONCLUSION

IP infections are moderately high among patients with HIV/AIDS in the study area. The proportion of parasites was greatly affected by high viral load, WHO stage 4, CD4 < 200 cell/mm3, and being barefoot; this gives valuable insight to health professionals, health planners and community health workers. As a result, viral load monitoring, and WHO stage controlling were periodically assessed in patients with HIV/AIDS. Health education, awareness creation, routine stool examination, and environmental hygiene were regularly advocated to increase the life of patients with HIV/AIDS.

Investigating Environmental Determinants of Soil-Transmitted Helminths Transmission using GPS Tracking and Metagenomics Technologies

Background

The Global Health community aims to eliminate soil-transmitted helminth (STH) infections by 2030. Current preventive methods such as Mass Drug Administration, WASH practices, and health education needs to be complimented to halt transmission. We tracked the movement of hookworm-infected and non-infected persons and investigated soil factors in the places they frequented within an endemic community to further understand the role of human movement and sources of infections.

Methods

59 positive and negative participants wore GPS tracking devices for 10 consecutive days and their movement data captured in real time. The data was overlaid on the community map to determine where each group differentially spent most of their time. Soil samples were collected from these identified sites and other communal places. Physical and chemical properties were determined for each sample using standard methods and helminth eggs cultured into larvae using the Baermann technique. Bivariate and multivariate analyses were used to determine associations between larvae counts and soil factors. Helminth species were identified with metagenomic sequencing and their distributions mapped to sampling sites in the community.

Results

The study found that there was no significant difference in the average larvae counts in soil between sites assessed by infected and non-infected participants (P=0.59). However, soil factors, such as pH, carbon and sandy-loamy texture were associated with high larvae counts (P<0.001) while nitrogen and clay content were associated with low counts(P<0.001). The dominant helminth species identified were Panagrolaimus superbus (an anhydrobiotic helminth), Parastrongyloides trichosuri (a parasite of small mammals), Trichuris trichuria (whipworm), and Ancylostoma caninum (dog hookworm). Notably, no Necator americanus was identified in any soil sample.

Conclusion

This study provides important insights into the association between soil factors and soil-transmitted helminths. These findings contribute to our understanding of STH epidemiology and support evidence-based decision-making for elimination strategies.

Prevalence of intestinal parasites and associated risk factors in HIV positive and negative patients in Northwest Region, Cameroon

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.

Assessment of intestinal parasites and associated factors among HIV/AIDS patients on antiretroviral therapy at Bule Hora General Hospital, West Guji, Ethiopia

Objective:

The study aimed to assess the prevalence of intestinal parasites and associated factors among people living with HIV/AIDS on antiretroviral therapy at Bule Hora General Hospital, West Guji, Oromia, Ethiopia.

Introduction:

Parasitic infection of the intestinal tract is a major source of disease in patients with HIV, particularly in the tropics, where diarrhea is a common complaint with variable severity.

Method:

An institution-based cross-sectional study was conducted from May to August 2021 on 179 systematic randomly selected HIV patients. Data on sociodemographics were collected by interviewing the study subjects using a pretested structured questionnaire. Stool specimens were collected from the study subjects and processed and examined by formol-ether concentration techniques. Data were obtained from each individual using data sheets and then entered into SPSS version 20 for analysis. The chi-square test was calculated, and a p value <0.05 was considered statistically significant.

Results:

Out of 179 study subjects, 52 (29.1%) were infected with intestinal parasites. The most frequently detected parasites were Giardia lamblia (38.5%) and Ascaris lumbricoides (25%) Entamoeba histolytica/dispar (15.4%), followed by Strongyloides stercoralis (11.5%). Factors such as the CD4+ T-cell status and source of drinking water were significantly associated with the prevalence of intestinal parasites among HIV/AIDS patients. The prevalence of intestinal parasites was highly observed among patients who scored CD4+ T cells <200 cells/mm³ 90.4% (47/52) and drink ground water 73.1% (38/52).

Conclusion:

There was moderate prevalence of intestinal parasites among HIV/AIDS patients; therefore, treating unprotected water before drinking and diagnosis of early parasites for HIV/AIDS patients whose CD4+ T-cell count is less than 200 cells/mm³ should be practiced to prevent intestinal parasite infection.

Intestinal Parasitic Infection and Associated Risk Factors among HIV-Infected Patients Seeking Healthcare in a Rural Hospital in Ghana

Background

Parasitic infections among human immunodeficiency virus (HIV)-infected patients are common in various regions and populations across the world and have since remained a persistent public health challenge. Sub-Saharan Africa harbors the greatest burden of the infections due to sociodemographic and behavioral factors. However, the prevalence of gastrointestinal parasitic infections among HIV-infected persons has been poorly investigated in Ghana.

Aim

This study sought to determine the prevalence of gastrointestinal parasitic infections and associated factors in HIV-infected individuals attending the antiretroviral therapy (ART) clinic in St. Mary Theresa Hospital, Dodi Papase.

Methods

A cross-sectional study was conducted from June 2021 to September 2021 among three hundred and thirty-five HIV-infected individuals in the study area. Sociodemographic and behavioral factors were collected with the aid of a close-ended structured questionnaire. Furthermore, stool samples were collected from each participant and examined for the presence of intestinal parasites by microscopy using direct wet mount, formol-ether concentration, and modified Ziehl–Neelsen (Zn) techniques. Data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 22.0 and Graphpad Prism version 8.

Results

The prevalence of gastrointestinal parasitic infections was 5.97%. Species-specific prevalence was found to be 2.99% for Giardia lamblia, 1.19% for Ascaris lumbricoides, and 0.90% each for Entamoeba histolytica/dispar and Trichuris trichiura. There was a significant association between participants' educational level and intestinal parasitic infection. In addition, gastrointestinal parasitic infections were not found to be associated with age. Unemployed participants, those with a lower frequency of deworming, and those who do not use water closet toilet facilities were at a higher risk of getting infected.

Conclusion

The lower infection rate recorded in this study suggests that public health interventions put in place are yielding significant results. Even though the prevalence is low, routine screening of all HIV-infected patients for parasitic infection is recommended to ensure timely, effective treatment and comprehensive care.