Prevalence of Cryptosporidium and Isospora belli in HIV/AIDS and non-HIV/AIDS patients at the Komfo Anokye Teaching Hospital, Kumasi.

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Waterborne diseases are very common especially in communities with low environmental and personal hygiene standards. Gryptosporidium and Isospora be/li are opportunistic pathogens implicated in diarrheal diseases in both immunocompetent and imniunoconipromised individuals. The disease is however more severe and protracted in immunocompromised, Human immunodeficiency virus infected persons. In infected persons, Gryptosporidiwn and Isospora beii causes malabsorption, diarrhea (with accompanying fluid loss and dehydration) and substantive weight loss with fatal consequences especially in children and HIV/AIDS patients. C,yptosporidium is particularly highly infectious. Presently, there are no universally effective treatment guidelines for cryptosporidiosis, many potential anticryptosporidial compounds have been complete failure in clinical trials. Isospora be/li has been implicated in traveler’s diarrhea. Isospora be/li however has been found to be sensitive to TrimethoprimSulfamethoxazole. The research at the Komfo Anokye Teaching Hospital Kumasi, aimed to investigate and determine the prevalence of Cryptosporidiurn and Isospora belli infection in the community, in HIV/AIDS and Non-HIV patients, in line with the quest for the first-of-its-kind, comprehensive surveillance data and information on the prevalence of Gryptosporidium and Isospora be/li infection, for the effective management of opportunistic Cryptosporidium and Isospora be/li infections in 11W/AIDS patients and for the general control of Gryptosporidium and Isospora be/li outbreak within the community. The modified acid-fast staining protocol (Kinyoun) was used for the demonstration and identification of Cryptosporidium and Isospora beili oocysts in fecal specimens. A generally high Jryptosporidiwn prevalence of 8.2% was recorded among the 413 (both H1V and non-HIV) patients examined at the Komfo Anokye Teaching Hospital Kumasi, between Dec.2003-Mar.2004. None of the patients examined tested positive for Isospora belli (an indication of the very low prevalence for this organism within the community). The research finding shows (Jryptosporidiurn is more prevalent in HIV/AIDS patients compared to non-HIV patients. A very high Cryptosporidium prevalence was recorded in diarrheal, symptomatic H1V positive patients (33.3%). Cryptosporidiuin was more prevalent in young children compared to other age groups examined. A trend of decreasing Cryptosporidium prevalence with increasing age was also observed. Strict adherence to preventive measures e.g. drinking boiled or adequately filtered bottled water is strongly recommended for HIV/AIDS patients and young children. More research into the exact role of the host immune system in establishing a disease state is warranted.
A thesis submitted to the Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements of Master of Science degree in Clinical Microbiology, 2004