Intestinal parasitic infection among the HIV-infected patients in Nepal

Abstract

Introduction: Intestinal parasitic infection has been a significant problem in HIV patients, worldwide. In this study, we aimed to measure the prevalence and identify the factors associated with intestinal parasitic infection in people infected with HIV and attending National Public Health Laboratory in Kathmandu, Nepal, for CD4 T-cell count. Methodology: An analytical cross-sectional study in 745 HIV-infected people attending for CD4 T-cell count was conducted. Results: The prevalence of intestinal parasitic infection was 22.4% (95% CI 19.5 to 25.5). In univariate analysis, age, sex, longer time since diagnosis of HIV, CD4 T-cell count of <200/µL, diarrhoea, marital status, and being under tuberculosis (TB) treatment were significantly associated with increased odds of intestinal parasite infection. However, in the logistic regression model, only the CD4 T-cell count of <200/µL (adjusted OR=4.2, 95% CI 2.5 to 7.0), diarrhoea (adjusted OR=2.8, 95% CI 1.8 to 4.3) and being under TB treatment (adjusted OR=2.9, 95% CI 1.8 to 4.6) remained as significant predictors. On stratification, CD4 T-cell count of <200/ µL was independently associated with higher odds of protozoal as well as helminthes infection. The parasites Cryptosporidium and Cyclospora were observed only in participants with CD4 T-cell counts <200/µL. Conclusions: Both protozoal and helminthic intestinal parasitic infections are common in HIV-infected people seeking care in healthcare facilities. The poor immune status as indicated by low CD4 T-cell count and TB may account for such a high risk of parasitic infection.

A cross-sectional analysis of intestinal parasitic infections among the general population in north of Iran

“…The IPIs can cause mortality and morbidity, and is associated with symptoms such as gastrointestinal disorders, malabsorption syndromes, psychosocial problems, growth retardation in children and iron deficiency anemia [4][5][6]. Individuals are susceptible to parasitic infections in all ages; however, children are more commonly inflicted with the effect of these pathogens [7].…”

Prevalence of intestinal parasitic infections among people living with HIV/AIDS visiting a central hospital of Kathmandu Nepal

“…12 In 2011, in hospital visiting patients, it was 21.4% 13 and in the people included in a survey was 15.17%. 4 Lower CD 4 T-cell counts; diarrhea; sex and some other factors were associated with increased IPI among PLHA. 4 IPI creates a huge concern in the management and care of PLHA.…”

“…4 Lower CD 4 T-cell counts; diarrhea; sex and some other factors were associated with increased IPI among PLHA. 4 IPI creates a huge concern in the management and care of PLHA. Detecting these parasite and understanding the status and significance of the infection they cause will greatly help in proper therapeutic management of these people and will prevent further infection.…”

“…10 It has been estimated that there are more than 60,000 PLHA in Nepal. 4 Similarly, IPI is highly prevalent among the general population of Nepal. 11 It is alone one of the most common public health problem in all over Nepal.…”

“…3 It's endemic in many developing countries of Asia and Africa due to poor sanitation, poor hygiene and unavailability of safe drinking water. 4 Diarrhoea is a common gastrointestinal symptom in HIV positive patients occurring in more than 90% of patients in developing countries and 30-60% of patients in developed countries. It is an independent indicator of mortality and morbidity in PLHA.…”