Intestinal parasitic infections and its association with undernutrition and CD4 T cell levels among HIV/AIDS patients on HAART in Butajira, Ethiopia

Abstract

BackgroundIntestinal parasitic infections and HIV/AIDS have been the major public health problems and remain a vital cause of morbidity and mortality in developing countries. Both problems are linked in a vicious cycle. The magnitude of intestinal parasites was prevalent among people living with HIV/AIDS even in the HAART era. However, the pertinent risk factors associated with intestinal parasites among HIV/AIDS patients were not well investigated in Ethiopia particularly at Butajira town. Therefore, the aim of this study was to determine the prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients on HAART in Butajira, Ethiopia.MethodA cross-sectional study was conducted, and a total of 323 study subjects was involved in the study. A systematic random sampling technique was used to select each participant during data collection. Stool specimen was collected and processed using direct wet mount, formol-ether concentration technique, and modified Ziehl-Neelson staining techniques to identify both common and opportunistic intestinal parasites. Structured questionnaire was used to collect socio-demographic, environmental, clinical, and nutritional data. Both bivariate and multivariate logistic regression analyses were used to assess the association of various explanatory factors on intestinal parasites. P value ≤0.05 at 95% CI was considered statistically significant.ResultsThe overall prevalence of intestinal parasites was 35.9% (95% CI 31.0–40.9%). Protozoa’s (Entanmoeba histolytica/dispar trophozoite, E. histolytica/dispar cyst, Giardia lamblia trophozoite, and G. lamblia cyst), helminths (Tanea species, Ascaris lumbricoides, Strongyloid stercoralis, Hookworm species and H. nana), and opportunistic intestinal parasites (Cryptosporidium parvum, Isospora belli) were observed in 57 (17.1%), 46 (14.4%), and 28 (8.7%) study participants respectively. Multivariate logistic regression analysis revealed that the presence of animals (AOR 6. 14; 95% CI 3.13, 12.0); using river water (AOR 4.87; 95% CI 1.14, 20.7); undernutrition (AOR 2.59; 95% CI 1.36–4.95); and level of immunosuppression (AOR 4.02; 95% CI 1.78–9.05 and AOR 2.84; 95% CI 1.37–5.89) were significantly associated with intestinal parasites.ConclusionsThe prevalence of intestinal parasites found to be higher among HIV/AIDS patients receiving HAART at Butajira Hospital, southern Ethiopia. Presence of animals, using river water, lower CD4 T cell count, and undernutrition were significant factors affecting intestinal parasites. Therefore, consistent detection of intestinal parasites and deworming of patients should be performed as well as improving health education on personal hygiene, avoiding contact with pit or domestic animals, and using safe or treated water. Furthermore, improving nutritional support and household food access are recommended.

Intestinal Parasitemia and HIV/AIDS Co-infections at Varying CD4+ T-cell Levels

“…Both problems are linked in a vicious cycle. 1 The introduction of antiretroviral therapy has lessened the prevalence of gastrointestinal infections in HIV patients. This notwithstanding, several people with HIV infection still suffer from intestinal parasite infections.…”

“…1,[6][7][8]25 Intestinal parasitic infections found among HIV patients from low-income countries have been reported with prevalence 15% to over 80% in recent times. 1,[6][7][8]25 In the current study, the overall prevalence of intestinal parasite among the study population was 19.3%. However, the prevalence of intestinal parasites in the HIV seropositive group was significantly higher (25%) than that observed in the HIV seronegative group which was 13.3%.…”

“…1 Currently, about 23.5 million people, an estimated 69% of all people living with HIV and AIDS, live in sub-Saharan Africa. 2,3 Moreover, 90-92% of all pregnant women and children living with HIV are reportedly living on the continent.…”

Causes for diarrhoea and infection with intestinal parasites among HIV positive patients at a referral hospital in Central Ethiopia

“…from Nigeria (5) or southern India (6), but lower than the prevalence described in previous studies from Ethiopia (i.e. from Desie (7), Butajira (8) and Bahir Dar (9)). The highest prevalence of intestinal parasitosis among HIV-positive individuals (80.3%) was described from an investigation in Bahir Dar in northwest Ethiopia (9).…”

Molecular Characterization and Clinical Description of Non-Polio Enteroviruses Detected in Stool Samples from HIV-Positive and HIV-Negative Adults in Ghana

“…As known, the depletion of CD4+ T lymphocytes and the associated impairment of the immune system make HIV patients more vulnerable to acquiring other infections and to developing more severe clinical manifestations [31]. Remarkably, co-infections with enteric parasitic infections are reported to worsen the progression of the HIV infection to Acquired Immunodeficiency Syndrome (AIDS) [32]. On the contrary, a potential beneficial immunomodulatory effect was evidenced in case of co-infection with Helicobacter pylori in HIV-positive persons [33,34].…”