Prevalence of Cryptosporidium spp. and Blastocystis hominis in faecal samples among diarrheic HIV patients in Medan, Indonesia.

Aim To investigate the prevalence of Cryptosporidium sp. and B. hominis among human immunodeficiency virus (HIV) positive patients in two different outpatient clinics, Haji Adam Malik General Hospital and Primary Care Centre of Padang Bulan, Medan, Indonesia, between two interval periods. Method Cryptosporidium spp. microscopic examination, as well as Jones' medium for B. hominis, were conducted in the Parasitology Laboratory, enzyme-linked immunosorbent assay (ELISA) was done in the Multidisciplinary Laboratory, Faculty of Medicine, Universitas Sumatera Utara. This was a cross-sectional study, involving 54 diarrheic HIV positive patients (44 males, 10 females). The data were analysed by Spearmen rank correlation, interrater agreement, and 2 tests. Results Infection rate for Cryptosporidium spp. and B. hominis was 24% (13 patients) and 9% (five patients), respectively. The prevalence of CD4 cell count below 200 cell/mm3 was relatively high, 29.6% (16 patients). There was a significant relationship between cryptosporidiosis and CD4 cell count (p=0.01; OR 1.57; 95% CI 1.25-1.99). Microscopic examination was superior over ELISA, whose diagnostic value for sensitivity and specificity was 46.15% and 100.0%, respectively, and Kappa (K) coefficient of 0.56. Conclusion The prevalence of cryptosporidiosis among HIV patients was still relatively high. CD4 count showed a significant relationship with Cryptosporidium spp. infection, but not with Blastocystic hominis. Microscopic examination is still the most reliable technique to diagnose the parasites in faecal samples.

Cryptosporidium Sp. Findings and Its Symptomatology among Immunocompromised Patients.

BACKGROUND: Cryptosporidium sp. is an apicomplexan protozoa, and it is related to an immunocompromised state. As it develops diverse clinical manifestations, mild to life-threatening conditions, administration of anti-parasitic medication and its management remain problematic. AIM: The study aimed to provide Cryptosporidiosis symptomatology and its prevalence among HIV-infected patients in a tertiary referral hospital, Haji Adam Malik General Hospital, Medan, Indonesia. MATERIAL AND METHODS: Symptomatology was noted using short-questionnaire, and laboratory findings were obtained from the hospital medical record registry on the same day of admission. We enrolled 24 patients were suffered from HIV infection for a certain period and more than one-week diarrhoea including 18 males and 6 females. Routine faeces examination using wet mount, Kinyoun-gabet, and trichrome staining was performed for all samples in Parasitology Department, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. Numerical data were evaluated using the Mann-Whitney test while Fisher Exact test was used to determine any association between categorical variables. RESULTS: Our study found that 8 of 24 patients were positive with Cryptosporidium sp. while its symptomatology including abdominal cramp (66.7%), nausea and vomiting (70.8%), and fever (62.5%) is prevalent from our study. We obtained significant association between CD4 cell count (p = 0.006), diarrhea duration (p = 0.007), abdominal pain (p = 0.005), and nausea and vomiting (p = 0.021) with cryptosporidiosis. CONCLUSION: High consideration of several symptoms related to cryptosporidiosis leads a clinician to initiate prompt management particularly in a high-risk population.