Intestinal protozoa in HIV-infected patients in Apulia, 
South Italy

Brandonisio, O; Maggi, Paolo; Panaro, Maria Antonietta; Lisi, Sabrina; Andriola, A.; Acquafredda, Angelo; Angarano, Gioacchino

doi:10.1017/s0950268899003015

Cited by 54 publications

(30 citation statements)

References 38 publications

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“…However, the difference was not observed to be statistically significant (p = 0.14). This finding is similar to other studies performed elsewhere [7,26,28]. This could be explained in that females are the ones more engaged with domestic chores and farming which exposes them to intestinal parasites.…”

Section: Discussionsupporting

confidence: 92%

“…In this study, intestinal parasites were isolated using the formol ether concentration and the kato-katz techniques in addition to methods involving staining with the modified field stain and the modified Ziehl-Neelsen stain meanwhile the other studies performed elsewhere at best involved the use of only one concentration and one staining technique. The prevalence of intestinal parasites was also high compared to that reported in other countries, 27.9% in Apulia, Italy [26] and the 28.1% and 42.9% observed in Abuja and Abeokuta respectively in Nigeria [27]. However, the prevalence observed in this study was similar to the 81.8% reported in Tanzania [28] and the 79.3% in Osun state of Nigeria [29].…”

Section: Discussionsupporting

confidence: 73%

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Prevalence and Predisposing Factors to Intestinal Parasitic Infections in HIV/AIDS Patients in Fako Division of Cameroon

Nsagha

Njunda²,

Nguedia³

et al. 2017

AJEID

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Background: Understanding the epidemiology of intestinal parasitic infection is essential for the effective management of HIV infection in areas where intestinal parasites are also endemic. Data on the prevalence of intestinal parasitic infection in people living with HIV/AIDS (PLHWA) in Cameroon are sparse. This study was designed to determine the prevalence of intestinal parasitic infections, as well as assess the predisposing factors for the infection in PLHWA in Fako Division of Cameroon. Methods: This was a cross-sectional study conducted between April and July 2014. Stool specimen were collected from consented participants and examined for ova, cysts, larvae or oocytes using the Kato-Katz, Formalin-Ether Concentration, Modified Ziehl-Neelsen and Modified field staining techniques. Statistical analysis performed included the Chi-square test and logistic regression. P<0.05 was considered to be statistically significant. Results: At the end of the study, 300 participants were enrolled, the majority being females 236 (78.6%). The participants were between 21-70 years (mean±SD = 40±10) of age. The overall prevalence of intestinal parasites was 82.6% (95% CI: 78.4 -87.0). The prevalence of infection was associated with age, being more prevalent in the age group 51-60 years (p=0.032). Intestinal protozoa were more prevalent than intestinal helminthes (74.3% vs 11.3%). The parasites isolated included: Cryptosporidium parvum (44.0%), Blastocystis hominis (25.0%), Microsporidium spp. (21.0%), Entamoeba histolytica (7.3%), Ascaris lumbricoïdes (4.3%), Isospora belli (4.3%), Trichuris trichiura (2.3%), hookworm (2.7%), Hymenolepis nana (1.3%), Strongyloïdes stercoralis (0.7%), Cyclospora cayetatensis (3.7%) and Giardia lamblia (3.3%). The predisposing factors for infection with intestinal parasites included poor educational background (OR=0.33, p=0.02), unskilled worker (OR=0.27, p=0.04), well as a source of drinking water (OR=2.6, p=0.03), and living with cats as pets (OR=3.06, p=0.01). Conclusion: A very high prevalence of intestinal parasitic infection was observed in PLHWA. Major predisposing factors for intestinal parasites infection included primary level of education, ownership of cats as pets, wells as source of drinking water and having a blue collar job. Routine screening for intestinal parasites should be instituted as part of HIV care in Fako division of Cameroon to improve on the management of HIV. HIV, protozoa, helminthes, prevalence, predisposing factors, Fako Division, cameroon Keywords: BackgroundIntestinal parasites are highly endemic in Sub-Saharan Africa [1], a region which is currently experiencing the highest burden of HIV/AIDS [1]. With the overlap in the distribution of both diseases, co-infection with one or more intestinal parasites and HIV is therefore common in the region [2]. The incidence of Intestinal parasitic infections is approximately 50% in developed countries whereas it reaches up to 95% in developing countries [2]. Cameroon is among the Sub-Saharan African countries...

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 73%

Prevalence and Predisposing Factors to Intestinal Parasitic Infections in HIV/AIDS Patients in Fako Division of Cameroon

Nsagha

Njunda²,

Nguedia³

et al. 2017

AJEID

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“…Diarrhea was common and strongly associated in patients with low CD4 cell count. This finding is in agreement with similar studies [30][31][32]. In addition, HIV patients may be prone to oxidative stress that may contribute to the process of diarrhea and a study conducted in Tunisia among the general population has shown that the oxidative stress is associated with gastrointestinal disturbances including diarrhea [33].…”

Section: Discussionsupporting

confidence: 92%

Clinical Correlates of Diarrhea and Gut Parasites among Human Immunodeficiency Virus Seropositive Patients

Bisong¹

2017

Recent Advances in Biology and Medicine

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Cluster differentiation 4 (CD4) count estimation, which is not readily available in most resource poor settings in Nigeria, is an important indexdetermining commencement of antiretroviral therapy (ART). It is imperative for physicians who come in contact with these patients in such settings to recognize other parameters to evaluate these patients. The clinical correlates of diarrhea and gut parasites among human immunodeficiency virus (HIV)-seropositive patients attending our special treatment clinic were studied. Three hundred and forty consenting HIV-positive adult subjects were enrolled. Their stool and blood specimens were collected for a period of three months. Stool samples were analyzed for the presence of diarrhea and gut parasites. The patients were clinically evaluated by physical examination for the presence of pallor, dehydration, oral thrush, wasting lymphadenopathy, dermatitis, skin hyperpigmentation, and finger clubbing. Participants with diarrhea represented 14.1% of the population, while 21.5% harbored one or more parasites. In the subjects with diarrhea, 14.6% harbored gut parasites. The presence of diarrhea was associated with a low CD4 count. Clinically, oral thrush, wasting, and rashes were more reliable predictors of low CD4 count levels; whereas, the presence of pallor, dehydration, wasting, and rashes correlated with the presence of diarrhea. HIV patients presenting with pallor, dehydration, wasting, and rashes should be evaluated for the presence of diarrhea. The clinical variables associated with low CD4 count in this study may guide commencing antiretroviral therapy in resource poor settings.

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“…Respectively, the most common infectious agents of the chronic diarrhea, regardless of the number of CD4 cells, are: Clostridium diffi cile, Giardia lamblia, Entamoeba histolytica. In patients with a CD4 cells <100/mm3, the most common infectious agents of chronic diarrhea are: Microsporidia, Cryptosporidium spp., Mycobacterium avium complex, Isospora beli, Cyclospora cayetanensis, Cytomegalovirus (CMV) (especially in cases with CD4 cells < 50/mm3) [1,5,6,13].…”

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confidence: 99%

“…For patients with CD4 cell count between 100-200/mm3, it is enough to perform fl exible sigmoidoscopy and biopsy, because CMV infection is less likely to occur at higher CD4 count [7,9]. To establish intestinal protozoa is necessary to examine the stools with specifi c staining methods: Ziehl-Neelsen, Giemsa, Heidenhain, Masson [1,5,6,8]. If the result is negative, it is also recommended colonoscopy with intestinal biopsy and electron microscopy, and molecular techniques to demonstrate the antigen in feces.…”

mentioning

confidence: 99%

Etiologic Characteristics of Enterocolitis in Hospitalized HIV-Infected Patients for 3-Year Period (2013-2015)

Yancheva¹,

Strashimirov²,

Elenkov³

et al. 2016

Acta Medica Bulgarica

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Summary. Diarrhea is the most common gastrointestinal symptom in HIV-infected patients. The incidence and severity of diarrhea increase with progression of the immune defi ciency. In the literature, 30-60% of the patients with diarrhea among HIV-infected individuals remain without specifi ed etiological agent. The aim of this article is to present the incidence of enterocolitis among hospitalized HIV-infected patients over a 3-year period and the degree of etiological clarifi cation of the cause. The results of our analyses showed that 63% of the hospitalized HIV-infected patients for this period were with enterocolitis. Only in 30% of these patients etiological agent was isolated. The reasons for this are mainly fi nancial constraints and, therefore, virological investigations and further endoscopic and histopathological examination of the patients with negative for bacteria and parasites stool samples, were not performed. In the cases with isolated pathogen, an etiological treatment was carried out in parallel with highly active antiretroviral therapy, while in unsubstantiated cases an empirical treatment was carried out. Advanced immune defi ciency was associated with more severe course and worse prognosis of the enterocolitis. The treatment with highly active antiretroviral therapy, which leads to improvement of the immune status of the patients, is essential for the output of enterocolitis in HIV-infected patients.

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Intestinal protozoa in HIV-infected patients in Apulia, South Italy

Cited by 54 publications

References 38 publications

Prevalence and Predisposing Factors to Intestinal Parasitic Infections in HIV/AIDS Patients in Fako Division of Cameroon

Prevalence and Predisposing Factors to Intestinal Parasitic Infections in HIV/AIDS Patients in Fako Division of Cameroon

Clinical Correlates of Diarrhea and Gut Parasites among Human Immunodeficiency Virus Seropositive Patients

Etiologic Characteristics of Enterocolitis in Hospitalized HIV-Infected Patients for 3-Year Period (2013-2015)

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