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Endalamaw M, Alemneh A, Amare GA, Fenta A, Belew H. 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. AIDS Res Ther 2024; 21:32. [PMID: 38755680 PMCID: PMC11097487 DOI: 10.1186/s12981-024-00618-3] [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: 02/05/2024] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
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.
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Affiliation(s)
- Mengistu Endalamaw
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Abel Alemneh
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Gashaw Azanaw Amare
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
| | - Abebe Fenta
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Habtamu Belew
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
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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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The Clinical Features and Immunological Signature of Cyclospora cayetanensis Co-Infection among People Living with HIV in Ghana. Microorganisms 2022; 10:microorganisms10071407. [PMID: 35889126 PMCID: PMC9316080 DOI: 10.3390/microorganisms10071407] [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: 05/30/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 01/25/2023] Open
Abstract
Background: There is a paucity of information on the contemporary burden, disease patterns, and immunological profile of people living with HIV who are co-infected with C. cayetanensis in the post-antiretroviral therapy era. Methods: For this cross-sectional study, stool samples of 640 HIV-positive and 83 HIV-negative individuals in Ghana were tested for C. cayetanensis. Additionally, sociodemographic parameters, clinical symptoms, medical drug intake, and immunological parameters were assessed. Results: The prevalence of C. cayetanensis was 8.75% (n = 56) in HIV-positive and 1.20% (n = 1) in HIV-negative participants (p = 0.015). Within the group of HIV-positive participants, the prevalence reached 13.6% in patients with CD4+ T cell counts below 200 cells/µl. Frequencies of the clinical manifestations of weight loss and diarrheal disease were significantly higher in patients with C. cayetanensis compared to those without co-infection (36.36% vs. 22.59%, p = 0.034 and 20.00% vs. 4.90%, p < 0.001, respectively). The expression of markers of immune activation and exhaustion of T lymphocyte sub-populations was significantly elevated in patients colonized with C. cayetanensis. Conclusions: In the modern post-combined antiretroviral therapy (cART) era, the acquisition of C. cayetanensis among PLWH in Ghana is driven largely by the immunosuppression profile characterized by high expression of markers of immune activation and immune exhaustion.
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Ramezanzadeh S, Beloukas A, Pagheh AS, Rahimi MT, Hosseini SA, Oliveira SMR, de Lourdes Pereira M, Ahmadpour E. Global Burden of Cyclospora cayetanensis Infection and Associated Risk Factors in People Living with HIV and/or AIDS. Viruses 2022; 14:v14061279. [PMID: 35746750 PMCID: PMC9228463 DOI: 10.3390/v14061279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/13/2022] Open
Abstract
Cyclospora cayetanensis infections remain one of the most common protozoan opportunistic causes of gastrointestinal diseases and diarrhea among people living with HIV and/or AIDS (PLWHA). This study was conducted to provide a summary of the evidence on the global burden of C. cayetanensis infection and associated risk factors among PLWHA. Scopus, PubMed, Science Direct, and EMBASE were searched up to February 2022. All original peer-reviewed original research articles were considered, including descriptive and cross-sectional studies describing C. cayetanensis in PLWHA. Incoherence and heterogeneity between studies were quantified by I index and Cochran’s Q test. Publication and population bias were assessed with funnel plots and Egger’s asymmetry regression test. All statistical analyses were performed using StatsDirect. The pooled prevalence of C. cayetanensis infection among PLWHA was 3.89% (95% CI, 2.62–5.40). The highest prevalence found in South America was 7.87% and the lowest in Asia 2.77%. In addition, the prevalence of C. cayetanensis was higher in PLWHA compared to healthy individuals. There was a relationship between a higher C. cayetanensis prevalence in PLWHA with a CD4 cell count below 200 cells/mL and people with diarrhea. The results show that PLWHA are more vulnerable to C. cayetanensis infection and emphasizes the need to implement the screening and prophylaxis tailored to the local context. Owing to the serious and significant clinical manifestations of the parasite, an early identification of seropositivity is recommended to initiate prophylaxis between PLWHA with a CD4 count ≤200 cells/mL and PLWHA who do not receive antiviral therapy.
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Affiliation(s)
- Saba Ramezanzadeh
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz 51666-14766, Iran;
- Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz 51666-14766, Iran
| | - Apostolos Beloukas
- National AIDS Reference Center of Southern Greece, Department of Public Health Policy, University of West Attica, 11521 Athens, Greece;
- Molecular Microbiology & Immunology Lab, Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece
| | - Abdol Sattar Pagheh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand 97178-53577, Iran;
| | - Mohammad Taghi Rahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud 36147-73955, Iran;
| | - Seyed Abdollah Hosseini
- Department of Parasitology and Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari 33971-48157, Iran;
| | - Sonia M. Rodrigues Oliveira
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal;
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Maria de Lourdes Pereira
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal;
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence: (M.d.L.P.); or (E.A.); Tel.: +351-234-378141 (M.d.L.P.); +98-413-5428595 (E.A.); Fax: +98-413-3373745 (E.A.)
| | - Ehsan Ahmadpour
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz 51666-14766, Iran;
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz 51666-14766, Iran
- Correspondence: (M.d.L.P.); or (E.A.); Tel.: +351-234-378141 (M.d.L.P.); +98-413-5428595 (E.A.); Fax: +98-413-3373745 (E.A.)
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Iordanov RB, Leining LM, Wu M, Chan G, DiNardo AR, Mejia R. Case Report: Molecular Diagnosis of Cystoisospora belli in a Severely Immunocompromised Patient with HIV and Kaposi Sarcoma. Am J Trop Med Hyg 2022; 106:678-680. [PMID: 34844211 PMCID: PMC8832916 DOI: 10.4269/ajtmh.21-0289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 10/06/2021] [Indexed: 02/03/2023] Open
Abstract
Diarrhea in an immunocompromised patient has a broad infectious differential. Diagnosis is difficult despite advances in diagnostic modalities. We report a case of a 45-year-old Nigerian woman who immigrated to the United States 2 years ago. She presented to the hospital with gastrointestinal bleeding, newly diagnosed HIV, and disseminated Kaposi sarcoma. During hospitalization, the patient had an onset of watery diarrhea and high eosinophilia. Subsequent stool analysis using multi-parallel real-time quantitative polymerase chain reaction for 13 parasites was positive for Cystoisospora belli. The patient was treated with trimethoprim-sulfamethoxazole, but had relapsed disease when her antibiotics were stopped prematurely. After restarting trimethoprim-sulfamethoxazole, her diarrhea and eosinophilia improved, and she had undetectable Cystoisospora belli DNA on repeat stool quantitative polymerase chain reaction. This case highlights the importance of a thorough workup for diarrhea, including parasites, especially for immunocompromised patients. Antibiotic prophylaxis is recommended in patients with Cystoisospora belli and HIV/AIDS.
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Affiliation(s)
- Roumen Borilov Iordanov
- Infectious Diseases Section, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Lauren M. Leining
- Laboratory of Human Parasitology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
| | - Meng Wu
- Rheumatology & Infectious Diseases, PLLC, Houston, Texas
| | - Galant Chan
- Infectious Diseases Section, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Andrew R. DiNardo
- Infectious Diseases Section, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Rojelio Mejia
- Laboratory of Human Parasitology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas;,Address corresponding to Rojelio Mejia, Baylor College of Medicine, One Baylor Plaza, BCM 113, Houston, TX 77030. E-mail:
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da Silva RKM, Dib LV, Amendoeira MR, Class CC, Pinheiro JL, Fonseca ABM, Barbosa ADS. Balantidiasis in humans: A systematic review and meta-analysis. Acta Trop 2021; 223:106069. [PMID: 34339668 DOI: 10.1016/j.actatropica.2021.106069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 11/27/2022]
Abstract
Balantioides coli is a protozoan that infects different hosts species, including humans, with zoonotic transmission. The parasite, which lives in the large intestine and in other organs, can lead to serious infections that may culminate in death. Information about human balantidiasis is generally still very scanty. In view of the above, the purpose of this study was to analyze the epidemiological, clinical and laboratory characteristics of human balantidiasis based on a systematic review and meta-analysis. The scientific articles were retrieved from various databases and were subjected to descriptive analyses, chi-squared tests, and summarized on a forest plot and the heterogeneity index (I2). A total of 103 articles were eligible and included in this review. Out of these 103 articles, 75 were clinical case reports and 28 were epidemiological studies, indicating a frequency of 997 (3.98%) people potentially infected with B. coli. The publication dates of the analyzed articles ranged from 1910 to 2020, but the majority (68.9%) were published between 1998 and 2020. A considerable number of these articles were published in South America and Asia, mostly in Brazil and India, respectively. However, in Africa, Ethiopia, was observed the higher number of infected people (47.5%). A significant association (p < 0.05) was identified between proximity to pigs and positivity for B. coli, since more than 16% infected people were in proximity with pigs and/or their excreta. Infection by the protozoan was classified mainly as intestinal, and the predominant symptom was dysentery. Extraintestinal infections were found in 27 individuals, with colonization of the genitourinary tract frequently highlighted. Direct examination (17.2%), followed by an association of direct examination and sedimentation (45.7%), were the most commonly performed parasitological techniques, and the most frequently diagnosed form was trophozoites, corresponding to 22.5% of cases. The most common treatment for parasitized individuals (11.8%) was an association of tetracycline drugs with nitroimidazole derivatives. The articles retrieved, mainly epidemiological ones, used in meta-analysis showed high heterogeneity (I2> 50%, p < 0.05), impairing the retrieval and comparison of results. Some articles were found to provide incomplete information, making it difficult to retrieve and analyze variables. However, this review enabled us to compile and restate factors that appear to be associated with cases of human balantidiasis.
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Affiliation(s)
- Rayana Katylin Mendes da Silva
- Microbiology and Parasitology Department, Federal Fluminense University, Biomedical Institute, Professor Hernani de Mello Street, 101, São Domingos, Niterói, Rio de Janeiro 24210-130, Brazil
| | - Laís Verdan Dib
- Microbiology and Parasitology Department, Federal Fluminense University, Biomedical Institute, Professor Hernani de Mello Street, 101, São Domingos, Niterói, Rio de Janeiro 24210-130, Brazil; Toxoplasmosis and other Protozoosis Laboratory, Oswaldo Cruz Institut, Oswaldo Cruz Foudation, Brazil Avenue, 4365, Manguinhos, Rio de Janeiro 21045-900, Brazil
| | - Maria Regina Amendoeira
- Toxoplasmosis and other Protozoosis Laboratory, Oswaldo Cruz Institut, Oswaldo Cruz Foudation, Brazil Avenue, 4365, Manguinhos, Rio de Janeiro 21045-900, Brazil
| | - Camila Carvalho Class
- Microbiology and Parasitology Department, Federal Fluminense University, Biomedical Institute, Professor Hernani de Mello Street, 101, São Domingos, Niterói, Rio de Janeiro 24210-130, Brazil
| | - Jessica Lima Pinheiro
- Microbiology and Parasitology Department, Federal Fluminense University, Biomedical Institute, Professor Hernani de Mello Street, 101, São Domingos, Niterói, Rio de Janeiro 24210-130, Brazil
| | - Ana Beatriz Monteiro Fonseca
- Department of Statistics, Federal Fluminense University, Institute of Mathematics and Statistics, Professor Marcos Waldemar de Freitas Reis Street s / n, São Domingos, Niterói, Rio de Janeiro, 24210-200, Brazil.
| | - Alynne da Silva Barbosa
- Microbiology and Parasitology Department, Federal Fluminense University, Biomedical Institute, Professor Hernani de Mello Street, 101, São Domingos, Niterói, Rio de Janeiro 24210-130, Brazil; Toxoplasmosis and other Protozoosis Laboratory, Oswaldo Cruz Institut, Oswaldo Cruz Foudation, Brazil Avenue, 4365, Manguinhos, Rio de Janeiro 21045-900, Brazil.
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Betancourth S, Archaga O, Moncada W, Rodríguez V, Fontecha G. First Molecular Characterization of Cryptosporidium spp. in Patients Living with HIV in Honduras. Pathogens 2021; 10:pathogens10030336. [PMID: 33805766 PMCID: PMC8000384 DOI: 10.3390/pathogens10030336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/16/2021] [Accepted: 03/02/2021] [Indexed: 11/17/2022] Open
Abstract
Cryptosporidiosis is one of the most important causes of gastroenteritis in the world, especially in low- and middle-income countries. It is caused by the Apicomplexan parasite Cryptosporidium spp., and mainly affects children and immunocompromised people, in whom it can pose a serious threat to their health, or even be life threatening. In Honduras, there are no data on parasite species or on molecular diversity or Cryptosporidium subtypes. Therefore, a cross-sectional study was conducted between September 2019 and March 2020 for the molecular identification of Cryptosporidium spp. in 102 patients living with HIV who attended a national hospital in Tegucigalpa. Stool samples were analyzed by direct microscopy, acid-fast stained smears, and a rapid lateral flow immunochromatographic test. All samples that tested positive were molecularly analyzed to identify the species and subtype of the parasite using three different markers: gp60, cowp, and 18Sr. PCR products were also sequenced. Four out of 102 samples (3.92%) were positive for Cryptosporidiumparvum, and all were assigned to subtype IIa. These findings suggest a possible zoonotic transmission in this population.
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Affiliation(s)
- Sergio Betancourth
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (S.B.); (O.A.)
| | - Osman Archaga
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (S.B.); (O.A.)
| | - Wendy Moncada
- Servicio de Atención Integral para Pacientes que Viven con VIH/SIDA-Instituto Nacional Cardiopulmonar, Tegucigalpa 11101, Honduras; (W.M.); (V.R.)
| | - Vilma Rodríguez
- Servicio de Atención Integral para Pacientes que Viven con VIH/SIDA-Instituto Nacional Cardiopulmonar, Tegucigalpa 11101, Honduras; (W.M.); (V.R.)
| | - Gustavo Fontecha
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (S.B.); (O.A.)
- Correspondence: ; Tel.: +504-33935443
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Karshima SN, Karshima MN. Epidemiology of Cryptosporidium Infections among People Living with HIV/AIDS in Nigeria: Results of Systematic Review and Meta-analysis. Acta Parasitol 2021; 66:60-74. [PMID: 32683583 DOI: 10.1007/s11686-020-00253-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/06/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Cryptosporidium is implicated in diarrhea epidemics in many parts of the world and is said to be the most common protozoan cause of diarrhea among people living with HIV/AIDS (PLWHA) globally. To provide data on the burden of Cryptosporidium infections among Nigerians living with HIV/AIDS, we reported the prevalence, geographic distribution and Cryptosporidium species diversity among this population in Nigeria. METHODS We used the PRISMA guidelines to perform a systematic review and meta-analysis of articles published between January 1, 1995 and April 21, 2020. Pooled estimate (PE), heterogeneity, quality of each study and publication bias were determined using the random-effects model, Cochran's Q test, the 9 point Joanna Briggs Institute Critical Appraisal Instrument and the Egger's regression asymmetry test, respectively. RESULTS Forty-six articles reported 2612 positive cases of Cryptosporidium infections from 12,756 PLWHA examined in 20 Nigerian States and the Federal Capital Territory. Overall pooled estimate was 14.5% (95% CI 10.4-19.9) with a range of 0.3% (95% CI 0.0-1.8) to 43.7% (95% CI 35.6-52.3) across sub-groups, with the PEs in relation to CD4+ T cell count, species and age showing significant variations at p < 0.05. Cryptosporidium hominis was the most prevalent (3.5%, 95% CI 2.3-5.2) of the six Cryptosporidium species reported in Nigeria. CONCLUSION Cryptosporidium infections are moderately prevalent among PLWHA in Nigeria with the highest regional prevalence in the north-east. In addition to personal hygienic practices, the inclusion of Cryptosporidium screening as part of HIV/AIDS clinics in Nigeria will reduce the burden of the parasite among PLWHA in Nigeria.
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Wondmieneh A, Gedefaw G, Alemnew B, Getie A, Bimerew M, Demis A. Intestinal parasitic infections and associated factors among people living with HIV/AIDS in Ethiopia: A systematic review and meta-analysis. PLoS One 2020; 15:e0244887. [PMID: 33382867 PMCID: PMC7775096 DOI: 10.1371/journal.pone.0244887] [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: 08/03/2020] [Accepted: 12/17/2020] [Indexed: 12/13/2022] Open
Abstract
Background Intestinal parasitic infections are major public health problems throughout the world, particularly in people living with HIV/AIDS. People living with HIV/AIDS are vulnerable groups for a variety of diseases, hence they are easily affected by opportunistic and non-opportunistic intestinal parasites due to the weakening of their immunity. Therefore, this study aimed to estimate the pooled prevalence and factors associated with intestinal parasitic infections among people living with HIV/AIDS in Ethiopia. Methods Articles were identified through search engines in the online electronic databases PubMed/MEDLINE, EMBASE, HINARI, CINAHL, Cochrane Library, Google Scholar, and reference lists of previous studies following the PRISMA Protocol. Studies conducted between 2003 and 2020 with English language were included in this study. This review included papers with having high-quality NOS scores. Meta-analysis was computed using STATA version 11 software. Heterogeneity was assessed using the Cochrane Q-test and I2 test statistics. Subgroup and sensitivity analysis was employed with evidence of heterogeneity. Publication bias was determined using the funnel plot and Egger’s regression test statistic. Results This study included a total of twenty-two cross-sectional studies with 5,833 study participants. The mean age of the study participants was 35 years old. The pooled prevalence of intestinal parasitic infection among people living with HIV/AIDS in Ethiopia was 39.15% (95%CI: 32.34, 45.95). The pooled prevalence of intestinal parasitic infections among people living with HIV/AIDS who had taking ART and who had not to start ART was found to be 28.27% (95%CI 22.47, 34.06) and 41.63% (95%CI: 28.75, 54.52) respectively. Unavailability of latrine (AOR: 4.87, (95% CI: 2.39, 9.92)), CD4+ T cell count <200cells/μl ((AOR: 3.53, (95%CI: 1.98, 6.27)), and having a history of diarrhea (AOR: 4.79 (95%CI: 1.53, 14.99) were factors significantly associated with intestinal parasitic infections. Conclusion In this study, the overall pooled prevalence of intestinal parasitic infections among HIV/AIDS patients in Ethiopia was relatively high. CD4+ T-cell count <200cells/μl, unavailability of a latrine, and history of diarrhea were significantly associated with intestinal parasitic infections. Therefore, the policymakers and health care professionals could give special attention to the presence of latrines, early detection and treatment of intestinal parasitic infections, and early initiation of ART drugs.
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Affiliation(s)
- Adam Wondmieneh
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
- * E-mail:
| | - Getnet Gedefaw
- Department of Midwifery, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Birhan Alemnew
- Department of Medical Laboratory Sciences, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Addisu Getie
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Melaku Bimerew
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Asmamaw Demis
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Alemayehu E, Gedefie A, Adamu A, Mohammed J, Kassanew B, Kebede B, Belete MA. Intestinal Parasitic Infections among HIV-Infected Patients on Antiretroviral Therapy Attending Debretabor General Hospital, Northern Ethiopia: A Cross-Sectional Study. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:647-655. [PMID: 33149698 PMCID: PMC7604243 DOI: 10.2147/hiv.s275358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 09/25/2020] [Indexed: 01/10/2023]
Abstract
Background Parasitic infections are known causes of morbidity among HIV-infected patients with low CD4+ counts who are on antiretroviral therapy (ART), mainly as a result of immuno suppression. This study aimed to assess the extent of intestinal parasitic infection and related risk factors among HIV-infected patients attending ART clinic at Debretabor General Hospital, Northern Ethiopia. Methods A health facility-based cross-sectional study was conducted on 383 HIV-infected patients attending the ART clinic of Debretabor General Hospital, northern Ethiopia from December 2018 to March 2019. An interview-based structured questionnaire was used to gather sociodemographic and risk-factor data. About 5 g fresh stool and 4 mL venous blood were collected from each patient, then transported and tested in accordance with laboratory-standard operating procedures. Data obtained were entered into SPSS version 22.0 and analyzed. P<0.05 with 95% CI was considered statistically significant. Results The overall prevalence of intestinal parasites was 25.3%, with 18% and 23.8% by direct wet-mount and formol ether-concentration technique, respectively. Eight (2.1%) patients were infected by multiple parasites using the concentration technique. Ascaris lumbricoides was the most frequently identified parasite (n=23, 25.3%). Parasitic infection was significantly higher among illiterates (P=0.011), patients with CD4 count <200 cells/mm3 (P<0.001), and those who did not have a toilet in their home (P=0.049) than their counterparts. Conclusion Relatively higher prevalence of intestinal parasitic infection was found among HIV/AIDS patients. The distribution of intestinal parasites was greatly affected by illiteracy, reduced CD4+ counts, and absence of a toilet. Therefore, HIV/AIDS patients with low CD4+ counts should be diagnosed consistently for intestinal parasites with routine stool examinations, and awareness creation should be advocated to be included as an essential component of ART-monitoring strategies for improved patient care.
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Affiliation(s)
- Ermias Alemayehu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia
| | - Aderaw Adamu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia
| | - Jemal Mohammed
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia
| | - Brhanu Kassanew
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Berhanu Kebede
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Semera University, Semera, Ethiopia
| | - Melaku Ashagrie Belete
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia
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Lengongo JVK, Ngondza BP, Ditombi BM, M'Bondoukwé NP, Ngomo JMN, Delis AM, Lekounga PB, Bouyou-Akotet M, Mawili-Mboumba DP. Prevalence and associated factors of intestinal parasite infection by HIV infection status among asymptomatic adults in rural Gabon. Afr Health Sci 2020; 20:1024-1034. [PMID: 33402948 PMCID: PMC7751509 DOI: 10.4314/ahs.v20i3.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Intestinal parasites infections are endemic in Gabon. Nevertheless, they are rarely described in people living with HIV (PLHIV). OBJECTIVE The frequency of intestinal parasite infection was estimated and compared between HIV-positive and HIV uninfected individuals in Gabon; factors associated with intestinal parasites were also analysed. MATERIAL AND METHODS Using a cross-sectional study design sociodemographic data, life style habits, antiretroviral therapy, cotrimoxazole use and CD4 cell count were recorded.. Stool samples from participants living in Koulamoutou and Oyem were analysed using microscopy. Chi-squared or fisher's exact tests and logistic regression were performed. RESULTS Among participants (n=332), female gender was predominant (73.7%; n=135/183) and the median age was 45 [33-57] years old. Among 183 samples, 53.6% (n = 98/183) were infected by intestinal parasites. The proportion was higher (72.1%) in HIV negative participants compared to PLHIV (42.6%) (p <0.01). PLHIV were more frequently poly-infected. Infection was frequent in patients using external toilets and tap water (>70.0%). CONCLUSION Prevalence of intestinal parasites is higher in seronegative participants but polyparasitism is more frequent in PLHIV. Strategies are focused on HIV negative population, but this study shows the importance of sensitization for PLHIV to improve their quality of life.
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Laksemi DA, Suwanti LT, Mufasirin M, Suastika K, Sudarmaja M. Opportunistic parasitic infections in patients with human immunodeficiency virus/acquired immunodeficiency syndrome: A review. Vet World 2020; 13:716-725. [PMID: 32546916 PMCID: PMC7245710 DOI: 10.14202/vetworld.2020.716-725] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/02/2020] [Indexed: 02/01/2023] Open
Abstract
The number of human immunodeficiency virus (HIV) cases increases annually, and Indonesia has become the country with the fastest HIV/acquired immunodeficiency syndrome (AIDS) epidemic spread among the five Southeast Asian countries. Indonesia entered the critical phase of HIV/AIDS infections after 5 out of the 33 provinces, namely, Papua, Jakarta, Bali, West Java, and East Java, reported HIV/AIDS epidemic since 2004. In AIDS pathophysiology and immune-suppression are severe, thus, opportunistic intestinal parasitic infections that cause diarrhea in HIV infection may be fatal. Several studies have suggested that Cryptosporidium parvum, Isospora belli, and Blastocystis hominis are the most common intestinal protozoan parasites categorized as AIDS associated illness. Diarrhea caused by parasites is considerably suspected in the cases of chronic and persistent diarrhea in adults, in an era of increasing HIV/AIDS cases nowadays. The present review highlights the current advances in etiologic agents of HIV/AIDS opportunistic infections among countries, epidemiology and prevalence, lifecycle, risk factors, examination methods, and treatment.
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Affiliation(s)
- D A Laksemi
- Department of Parasitology, Faculty of Medicine, Udayana University, Bali, Indonesia
| | - L T Suwanti
- Department of Parasitology, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia.,Institute of Tropical Disease, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - M Mufasirin
- Department of Parasitology, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia.,Institute of Tropical Disease, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - K Suastika
- Department of Internal Medicine, Faculty of Medicine, Udayana University, Bali, Indonesia
| | - M Sudarmaja
- Department of Parasitology, Faculty of Medicine, Udayana University, Bali, Indonesia
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