A survey of urinary schistosomiasis among school aged children of ten communities in South-South, Nigeria.

BACKGROUND & OBJECTIVES: Schistosomiasis is one of the major neglected tropical parasitic diseases caused by a group of blood-feeding worms in the genus Schistosoma. Nigeria ranks highest among all countries worldwide, however, there is a paucity of information on the prevalence of the disease in some parts of the country. Therefore, the research aims to augment available data on the prevalence of Schistosoma haematobium infection among schoolaged children in ten communities in Edo state, Nigeria. METHODS: A cross-sectional survey involving 400 school-aged children was conducted in 10 randomly selected communities in Akoko-Edo Local Government Area, Edo State of Nigeria between November 2016 and April 2017. Demographic data of subjects was collected using a structured questionnaire. Urine samples were collected and examined for haematuria and ova of Schistosoma haematobium using a commercially prepared reagent strip (Medi-Test Combi9TMR) and sedimentation technique respectively. RESULTS: The prevalence of urinary schistosomiasis based on microscopic examination of the urine sediment for the ova of S. haematobium was 17.3%, while haematuria was 22.0%. Mean intensity of S. haematobium oval count ranged between 2.0-4.0/10ml of urine per community. Prevalence was higher among males (24.5%) than females (10.0%)(P<0.05), which was statistically significant. Overall, age group 7-9 years showed the highest prevalence of infection. Farming showed a strong correlation as a parent occupational risk factor in predisposing children to infection as it accounts for 73.9% of all infections. INTERPRETATION & CONCLUSION: Findings indicate that urinary schistosomiasis is still prevalent among school-aged children in Akoko-Edo LGA, which hinders their growth, development and cognitive abilities. Although, mass drug administration is ongoing in some of the communities, re-infection still occurs due to ignorance, occupational factors, lack of portable water and sanitary toilets.

Unusual Enterocytozoon bieneusi genotypes and Cryptosporidium hominis subtypes in HIV-infected patients on highly active antiretroviral therapy.

Human immunodeficiency virus (HIV)-infected persons are commonly infected with Cryptosporidium species and Enterocytozoon bieneusi in both developed and developing countries, particularly patients with CD4+ cell counts below 200 cells/µL; 285 HIV-infected patients on highly active antiretroviral therapy (HAART) were enrolled in this study, and both stool and blood specimens were collected from participants. The stool specimens were analyzed and typed for E. bieneusi and Cryptosporidium spp. by polymerase chain reaction (PCR) and DNA sequencing. CD4 count was analyzed using flow cytometry. E. bieneusi and Cryptosporidium were detected in 18 (6.3%) and 4 (1.4%) patients, respectively. The E. bieneusi detected mostly belonged to a new genotype group that, thus far, has only been found in a few humans: genotype Nig4 in 2 patients and two new genotypes related to Nig4 in 12 patients. The Cryptosporidium detected included C. hominis (two patients), C. parvum (one patient), and C. felis (one patient), with the two C. hominis infections belonging to an unusual subtype family. Additional studies are required to determine whether some E. bieneusi genotypes and C. hominis subtypes are more prevalent in HIV patients on HAART.

Molecular epidemiologic characterization of Enterocytozoon bieneusi in HIV-infected persons in Benin City, Nigeria.

Molecular characterization of Enterocytozoon bieneusi has led to better understanding of microsporidiosis transmission in humans. This study aimed to detect and genotype E. bieneusi in human immunodeficiency virus (HIV)-infected persons. Stool specimens were collected from 463 HIV-infected patients and analyzed for E. bieneusi by polymerase chain reaction (PCR) and DNA sequence analysis of the internal transcribed spacer. E. bieneusi was detected in 77 HIV patients. CD4 cell counts < 200 cells/µL was associated with E. bieneusi infection (P = 0.09). E. bieneusi was significantly associated with weight loss (P < 0.0001), diarrhea (P = 0.006), fever (P < 0.0001), not being married (P < 0.0001), and flush type of toilet (P = 0.0007). Six known genotypes of D, A, IV, CAF2, EbpA, and Peru 8 in 31, 22, 14, 2, 1, and 1 patients, respectively, five novel genotypes of E. bieneusi, and one infection with mixed genotypes were observed in this study. Three of the novel genotypes were genetically distant to the genotypes commonly found in humans.

Prevalence of intestinal parasites in relation to CD4 counts and anaemia among HIV-infected patients in Benin City, Edo State, Nigeria.

Parasitic infections continue to take their toll on HIV positive patients by influencing the blood qualitatively and quantitatively. The objective of this study was to determine the prevalence of intestinal parasitic infections in relation to anaemia and CD4 counts among HIV-infected patients in Benin City, Nigeria. Using a serial sampling method, a total of 2000 HIV-infected patients were recruited on their first visit prior to highly active anti-retroviral therapy (HAART) at the University of Benin Teaching Hospital from August 2007 to August 2009. Stool and blood samples were collected from each patient. The stool samples were processed using the modified Ziehl-Neelsen staining technique to microscopically identify the oocysts of Cryptosporidium species, Isospora belli, Cyclospora species and spores of Microsporidium species while saline and iodine preparations were used for identifying the ova, cysts and parasites of Ascaris lumbricoides, hookworm, Taenia spp and other parasites. The blood specimens were equally analyzed using the flow cytometry for CD4+ T-lymphocyte count and autoanalyzer - sysmex kx - 21 for haemoglobin concentration. The overall prevalence of anaemia was 93.3% while 18% had parasitic infections. There was a significant relationship between CD4 count <200cells/microL and anaemia (P<0.0001). Cryptosporidium species (P= 0.005), A. lumbricoides (P=0.035), hookworm and Taenia species (P=0.014) were associated with anaemia. Anaemia was associated with CD4 count while Cryptosporidium species, Ascaris lumbricoides, hookworm and Taenia species were the intestinal parasitic agents associated with anaemia. In conclusion the prevalence of anaemia in HIV-infected patients is high low CD4 count is a significant risk factor of acquiring anaemia. Except for isosporiasis, cryptosporidiosis, A. lumbricoides, hookworm and Taenia species in HIV infected individuals are parasitic agents associated with anaemia. Routine screening for intestinal parasites and holistic management of anaemia is advocated.

Prevalence of intestinal parasitic infections among HIV patients in Benin City, Nigeria.

This study was carried out to determine the presence of intestinal parasites and their correlation with CD4(+) T-cell counts and demographics among human immunodeficiency virus (HIV)-positive patients in Benin City, Nigeria. Stool specimens from 2,000 HIV-positive patients and 500 controls (HIV-negative individuals) were examined for ova, cysts, or parasites, using standard procedures. In addition, patient's blood samples were analyzed for CD4 counts by flow cytometry. An overall prevalence rate of 15.3% was observed among HIV-positive patients while 6.2% was noted among non-HIV subjects. HIV status was a significant (P<0.0001) risk factor for acquiring intestinal parasitic infections. Male gender, CD4 count <200cell/µl, and diarrhea were significantly associated with an increased prevalence of intestinal parasitic infections among HIV-positive patients. The level of education, occupation, and source of water among HIV patients significantly (P<0.0001) affected the prevalence of intestinal parasitic infections. Ascaris lumbricoides was the most predominant parasite in both HIV-positive patients and controls. A CD4 count <200 cells/µl was significantly associated with only Isospora belli and Cryptosporidium infections. The presence of pathogenic intestinal parasites such as A. lumbricoides, hookworm, Giardia intestinalis, Entamoeba histolytica, Trichuris trichiura, and Taenia species among HIV-infected persons should not be neglected. Cryptosporidium species and I. belli were the opportunistic parasites observed in this study. Routine screening for intestinal parasites in HIV-positive patients is advocated.