Gastrointestinal Parasitic Infections and Immunological Status of HIV/AIDS Coinfected Individuals in Nigeria.

BACKGROUND: Parasitic infections of the gastrointestinal tract is one of the highest causes of morbidity and mortality among HIV infected individuals. This is due to the colonization of the intestinal tract by parasites influenced by induced enteropathy caused by HIV infection. CD+4 t-lymphocytes count is a marker of the immune status of HIV infected individuals. OBJECTIVE: This study investigated the prevalence of gastrointestinal parasitic infections among HIV coinfected individuals in relation to their immunological status. METHODS: CD+4 t-lymphocytes count was determined using fluorescence-activated cell sorting (FACS) count system. Parasitological examination of faecal samples was conducted using direct wet mount, modified Z-N and Giemsa stain techniques. All prepared slides were examined under x10 and x40 objectives. FINDINGS: Out of the 891 HIV seropositive participants on antiretroviral therapy that were studied, 641 (71.9%) had CD+4 counts equals to or greater than 500 cells/mm3. All other seropositive participants had CD+4 counts below 500 cells/mm3. Gastrointestinal parasitic infections were recorded in 187 (20.9%) seropositive participants, with females (n = 108, 12.1%) having more infections than males. Multiple gastrointestinal parasitic infections were recorded in 28 (3.1%) seropositive participants. Out of the 150 seronegative participants, 79 (52.7%) of them had at least one gastrointestinal parasitic infection. Female seronegative participants also accounted for higher infection rate (n = 42, 28.0%) than males (n = 37, 24.7%). Multiple infections were also recorded in 18 (12.0%) seronegative individuals. The overall prevalence rate of infection between both positive and negative individuals was 25.5%. There was statistical significant difference in the infections of Cryptosporidium parvum (p < 0.003), Cyclospora cayetanensis (p < 0.011) and Cystoisospora belli (p < 0.011) between HIV seropositive and HIV seronegative individuals. Also, there was statistical significant difference in the infections of hook worm (p < 0.002) and Trichuris trichiura (p < 0.020) between seronegative and seropositive individuals. Gastrointestinal parasitic infection rate was significantly higher among seropositive participants with CD+4 counts between 200 and 350 cells/mm3 (n = 109, 58.3%). CONCLUSION: The study shows that HIV infected individuals continue to experience gastrointestinal infections even with antiretroviral treatment, especially those with CD+4 counts below 350 cells/mm3. Health care providers should prioritise routine screening of HIV patients for gastrointestinal parasites and provide prompt treatment. Antiparasitic drugs should also be provided as prophylaxis.

Socio-environmental factors and ascariasis infection among school-aged children in Ilobu, Osun State, Nigeria.

The risk factors predisposing children to ascariasis transmission in a rural community of Osun State, Nigeria were investigated from November 2005 to April 2006. Children below 16 years of age were examined at the household level after information on biodata, access to water supply and sanitation, socio-economic status of their parents and degree of cohabitation with their parents was collected using a questionnaire. Of 440 children examined, overall prevalence was 60% and median intensity was 1548 eggs per gram (epg) (min. 48 epg; max. 55464 epg). Infection patterns were gender comparable and age dependent, with peak prevalence (67.8%) occurring in children aged 5-9 years and peak median intensity (4368 epg) in children aged >or=15 years. Logistic regression analysis revealed that prevalence was influenced by patterns of water supply and sanitation, parents' educational background, number of biological parents living with a child and number of playmates a child has. These findings suggest that socio-environmental risk factors which play a role in disease transmission need to be taken into account when formulating sustainable control strategies for ascariasis and other intestinal parasites in Nigeria and elsewhere.

Diagnostic accuracy of different urine dipsticks to detect urinary schistosomiasis: a comparative study in five endemic communities in Osun and Ogun States, Nigeria.

The diagnostic accuracy of urine dipsticks was investigated using two different brands in five endemic communities of south-western Nigeria. The BM-5L test was used in 1992 to screen 566 subjects in two communities in Ogun State, while 1457 subjects in three other communities in Osun State were screened with the Combur-9 test in 2006. Haematuria gave a higher prevalence of infection than proteinuria irrespective of which strip brand was used (e.g. BM-5L test: 58.3 and 36.2%; Combur-9 test: 46.5 and 41.9%, respectively). Compared with egg microscopy (gold standard), haematuria identified over 90% of egg-positive samples using either the BM-5L test in 1992 or the Combur-9 test in 2006. The corresponding values for proteinuria were 58% using the BM-5L test and 82% using the Combur-9 test. Sensitivity of haematuria to infection was higher using the BM-5L test (92.4-93.5%) than Combur-9 (58.6-73.3%), while sensitivity of proteinuria to infection was higher using Combur-9 (55.5-80.4%) than BM-5L test (26.0-58.3%). However, both strip brands have comparable specificity for haematuria (BM-5L test, 88.3-99.5%; Combur-9, 88.9-100%) and proteinuria (BM-5L test, 94.4-100%; Combur-9, 98.7-100%) to infection. Based on these results we conclude that neither brand nor manufacturer has a significance effect on the performance of chemical reagent strips. However, the diagnostic value of both haematuria and proteinuria varied according to the positivity level adopted, intensity of infection and age, but was not affected by sex and village of residence.