Evaluation of intestinal parasite infections in hiv/aids patients on antiretroviral therapy (art) in selected Hiv Clinics in Cape Coast Metropolis.
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Date
2015-03-03
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Abstract
Intestinal parasites are a major concern in most developing countries. About 60% of
the world’s population are infected with intestinal parasites which are commonly
associated with HIV/AIDS disease. This study was designed to assess the prevalence
of intestinal parasite infections among adult HIV/AIDS patients on ART and those
not on ART. This hospital-based prospective study was conducted in three selected
HIV Clinics in the Cape Coast Metropolis. A total of 206 HIV positive patients aged
from 18 to 65 years, of both sexes, were involved in the study from January 2011 to
April 2012. Stool samples were collected from the participants and examined using
direct wet mount, formol-ether concentration method, Kato-Katz technique and
modified Ziehl-Neelsen (ZN) staining method. Blood samples were taken to analyze
their CD4+ T-lymphocyte count at each encounter. The stool examination and blood
analysis were repeated on their subsequent visits to the clinic for a period of six
months. Questionnaire on sociodemographic and medical history of participants was
administered. Data were analysed using SPSS version 19 software and p-value was set
at p<0.05.The overall prevalence of intestinal parasites in this study was 47.6 % with
a significant difference (p=0.012) between parasite-positive participants on ART
(19.9%) and those not on ART (27.7%). Most of the parasite-positive participants
(23.3%) had CD4+ counts below 200 cells/μL. Intestinal parasites detected in this
study included: Giardia lamblia (18.0%), Entamoeba histolytica (12.1%),
Cryptosporidium spp. (5.8%), Isospora belli (4.4%), Strongyloides stercolaris
(3.9%), Ascaris lumbricoides (1.9%) and Trichuris trichiura (1.5%). G. lamblia and
E. histolytica were the most prevalent. Cryptosporidium spp. (p=0.021) and I. belli
(p=0.020) infections were significantly higher in participants who were not on ART,
which participants were also significantly associated (p=0.020) with CD4+ counts
below 200 cells/μL. G. lamblia (p=0.002), E. histolytica (p=0.028), Cryptosporidium
spp. (p=0.021) and I. belli infections (p=0.020) were significantly associated with
patients with diarrhoea stools. The overall prevalence of intestinal parasites of the
study differed by ART status. Patients on ART had lower prevalence of intestinal
parasites and most of the intestinal parasite infections were associated with lower
CD4+ counts. This study has established that HIV/AIDS disease coexists with
intestinal parasite infections, therefore, stool examination should be reinforced as part
of the routine laboratory investigations for the management of HIV/AIDS patients.
Description
A Thesis submitted to the Department of Clinical Microbiology, School of
Medical Sciences, College of Health Sciences in partial fulfilment of the requirements for the degree of Master of Philosophy.