Intestinal protozoan infections among HIV positive persons with and without Antiretroviral Treatment (ART) in selected ART centers in Adama, Afar and Dire-Dawa, Ethiopia

Abstract

Background: In developing countries, gastroenteritis caused by intestinal parasites may be complicated and is a major cause of morbidity, in general, and kills millions of AIDS patients annually. Thus, the consequences of parasitic diseases are among the major health problems in tropical developing countries. Methods: A total of 200 HIV positive patients on and without-ART aged from 18 to 65 years, of both sexes participated in the study. Each study participant was provided with a faecal collection vial containing 10% formalin for microscopic examination of ova, larvae, and cysts. For detection of Cryptosporidium spp, lsospora belli and
Cyclospora spp, the modified Zeihl-Neelsen staining method was used. Results: Most (60%) of the study participants were on antiretroviral therapy (ART). Out of those, only two (1.5%) were diagnosed with an opportunistic parasite, and 96 (48%) of the non-ART study participants were infected with at least one other intestinal parasite species. The prevalence was 16% for Giardia lamblia, 13% for Entamoeba histolytica/ E. dispar, 8% for Cryptosporidium spp, 5% for Isospora belli, 1.5% for Blastocystis hominis, 2.5% for Ascaris lumbricoides and 2% for Hymnolepis nana. Diarrhoea was significantly associated with cryptosporidiosis, giardiasis, and isosporiasis. Significant association was observed between lower CD4+ T cell count (<200 cells/μL) and the prevalence of Cryptosporidium spp, Isospora belli, and Blastocystis hominis. The three parasites were significantly prevalent in HIV sero-positive patients not on -ART. Conclusion: The finding showed that patients under ART had lower prevalence of diarrheogenic protozoan parasites suggesting that ART through improvement of the immune status of patients may have contributed to controlling parasites in HIV/AIDS patients.