Intestinal protozoan infections among children 0-168 months with diarrhea in Mozambique: June 2014 - January 2018

Background: Human immunodeficiency virus (HIV) and intestinal parasites co-infections are the most common causes of clinical illness and death, especially for children living in resource constrained setting. Therefore, the aim of this study was to determine the prevalence and associated factors of intestinal parasites among highly active anti-retroviral therapy (HAART) initiated children. Methods: Cross-sectional study was conducted among 255 HAART initiated HIV-infected children at the University of Gondar Comprehensive Specialized Hospital from January to April 2020. Socio-demographic characteristics were collected using a structured questionnaire via a face-to-face interview. Clinical data of the children were collected by reviewing the medical records. Venous blood was collected for complete blood counts, viral load determination, and blood film examination. Flotation concentration technique was done in addition to direct wet mount for parasitological examination. Bi-variable and multi-variable logistic regression analysis were used to check the presence of significant association, and P-value<0.05 was considered as statistically significant. Results: The overall prevalence of intestinal parasite infection (IPI) among the study participants was 22.4% (95% CI=17-28%). The presence of opportunistic infection (AOR=2.09 95% CI=1.81-5.43), no eating under-cooked animal products (AOR=0.38 95% CI=0.16-0.94), male sex (AOR=0.45 95% CI=0.22-0.90), viral load rate >1,000 copies/mL (AOR=1.80 95% CI=1.67-4.19), and cytopenia (AOR=2.71 95% CI=1.59-12.25) showed significant association with the prevalence of IPI. Conclusion: Entamoeba histolytica and Ascaris lumbricoides were the most prevalent intestinal parasites among HAART initiated children. Among HAART initiated children, IPI were associated with gender, cytopenia, viral load, undercooked animal products, and the presence of opportunistic infections. Therefore, health education, prompt treatment, and regular deworming should be implemented to alleviate the burden of intestinal parasites in HIV-infected children.

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“…The result in this study showed less frequency as compared to the finding reported in Mozambique (12%) among diarrheic hospitalized children. 31 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of Intestinal Parasitic Infection and Associated Factors Among HAART Initiated Children Attending at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Bayleyegn

Woldu

Yalew

et al. 2021

HIV

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“…Hospital Central da Beira (HCB) in Sofala; Hospital Geral de Quelimane (HGQ) in Zambézia, and Hospital Central de Nampula (HCN) in Nampula. ViNaDia’s methodology has been previously described [ 20 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

Rotavirus A infection in children under five years old with a double health problem: undernutrition and diarrhoea – a cross-sectional study in four provinces of Mozambique

et al. 2021

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Background Mozambique has a high burden of group A rotavirus (RVA) infection and chronic undernutrition. This study aimed to determine the frequency and potential risk factors for RVA infection in undernourished children under 5 years old with diarrhoea in Mozambique. Methods The analysis was conducted using data from March 2015 to December 2017, regarding children under 5 years old with at least one type of undernutrition. Anthropometric measures were used to calculate indices of weight-for-age, weight-for-height and height-for-age through the Z-Scores. RVA results were extracted from the National Diarrhoea Surveillance database. Descriptive statistics, chi-square test was used for qualitative variables and organized in contingency tables and 95% Confidence Intervals (CI) were considered for the calculation of RVA infection proportion and in the multiple logistic regression models to estimate the adjusted odds ratios (AOR). Results Of the 842 undernourished children included in the analysis, 27.2% (95% CI: 24.3–30.3%) were positive for RVA. The rate of RVA infection was 42.7% (95% CI: 38.0–47.5%) in the pre-vaccine period, with great reduction to 12.2% (95% CI: 9.4–15.6%) in the post-vaccine period. Most of the RVA undernourished children had severe wasting (33.3%) and severe stunting (32.0%). The risk of infection was significantly high in children from 0 to 11 months (p-value < 0.001) when compared to the age group of 24–59 months. A higher proportion of RVA infection was detected in households with five or more members (p-value = 0.029). Similar proportions of RVA were observed in children fed only by breast milk (34.9%) and breast milk with formula (35.6%). A higher proportion of undernourished HIV-positive children co-infected with RVA (7.4%) was observed. Conclusions The frequency of RVA infection in undernourished children declined following the introduction of the vaccine in Mozambique. Beyond the temporal variation, Maputo province, age and crowded households were also associated to RVA infection. A high proportion of RVA infection was observed in children with severe wasting and a triple burden of disease: undernutrition, RVA and HIV, highlighting the need to conduct follow-up studies to understand the long-term impact of these conditions on children’s development.

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“…is the most attributable to moderate-to-severe diarrhoea in children younger than five in sub-Saharan Africa and Asia [ 3 ]. The second and third most common intestinal protozoa identified in children with diarrhoea are Giardia lamblia and Entamoeba histolytica , respectively [ 5 – 7 ] .…”

Section: Introductionmentioning

confidence: 99%

“…A pooled analysis of a surveillance system in four provinces of Mozambique indicated Nampula province as the one with the highest risk of infection for Cryptosporidium spp. in children younger than 15 years [ 5 ]. Nampula province has poor health indicators, with recurrent reports of cholera outbreaks [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Nampula province has poor health indicators, with recurrent reports of cholera outbreaks [ 19 ]. The previous results from the surveillance system ( Vigilância Nacional de Diarreias – ViNaDia or National Surveillance of Diarrhoea) failed to indicate risk factors for protozoans in each province [ 5 ]. Therefore, this analysis aims to determine the frequency of intestinal protozoa infections and associated risk factors in children younger than five years admitted with diarrhoea in Hospital Central de Nampula , in the Northern region of Mozambique.…”

Section: Introductionmentioning

confidence: 99%

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Intestinal protozoa in hospitalized under-five children with diarrhoea in Nampula – a cross-sectional analysis in a low-income setting in northern Mozambique

et al. 2021

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Background In Mozambique, infection by intestinal parasites is reported all over the country. However, infection in children with diarrhoea is mostly focused in the southern region of Mozambique. This work aims to determine the frequency and potential risk factors for infection by Cryptosporidium spp., Giardia lamblia, and Entamoeba histolytica in children under-five years hospitalized with diarrhoea in Hospital Central de Nampula, northern Mozambique. Methods A cross-sectional hospital-based surveillance was conducted between March 2015 and January 2018 in children admitted with diarrhoea in Hospital Central de Nampula. Sociodemographic information was obtained through semi-structured interviews applied to the children’s caregivers. A single stool sample was collected from each child to detect antigens from Cryptosporidium spp., G. lamblia, and E. histolytica using an immune-enzymatic technique. Crude and adjusted odds ratios (with 95% Confidence Intervals) were obtained by logistic regression models to identify factors associated with infection by Cryptosporidium spp. and G. lamblia. Results The median age and interquartile intervals of our sample population was 12 months (8–20). Intestinal protozoa were detected in 21.4% (59/276). Cryptosporidium spp. was the most common protozoa (13.9% - 38/274), followed by G. lamblia (9.1% - 25/274) and E. histolytica (0.4% - 1/275). Children with illiterate caregiver’s (p-value = 0.042) and undernourished (p-value = 0.011) were more likely to be infected by Cryptosporidium spp. G. lamblia was more common in children living in households with more than four members (p-value = 0.039). E. histolytica was detected in an eleven month’s child, co-infected with Cryptosporidium spp. and undernourished. Conclusion Cryptosporidium spp. and Giardia lamblia were the most common pathogenic intestinal protozoa detected in children with diarrhoea hospitalized in the Hospital Central de Nampula. Our findings obtained highlight the importance of exploring the caregiver’s education level, children’s nutritional status for infections with Cryptosporidium spp., and living conditions, namely crowded households for infections with G. lamblia in children younger than five years.

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Intestinal protozoan infections among children 0-168 months with diarrhea in Mozambique: June 2014 - January 2018

Cited by 24 publications

References 28 publications

Prevalence of Intestinal Parasitic Infection and Associated Factors Among HAART Initiated Children Attending at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Prevalence of Intestinal Parasitic Infection and Associated Factors Among HAART Initiated Children Attending at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Rotavirus A infection in children under five years old with a double health problem: undernutrition and diarrhoea – a cross-sectional study in four provinces of Mozambique

Intestinal protozoa in hospitalized under-five children with diarrhoea in Nampula – a cross-sectional analysis in a low-income setting in northern Mozambique

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