Cryptosporidiosis And Other Intestinal Parasitic Infections And Concomitant Threats Among HIV-Infected Children In Southern Ethiopia Receiving First-Line Antiretroviral Therapy

Abstract

Background

Children infected with human immunodeficiency virus (HIV) are at high risk of acquiring intestinal parasitic infections. This study aimed to determine the magnitude of Cryptosporidium and other intestinal parasitic infections and concomitant threats among HIV-infected children.

Methods

A hospital-based cross-sectional study was carried out at three antiretroviral therapy clinics in southern Ethiopia from February 2016 to June 2017 in 384 HIV positive children. Socio-demographic and clinical data were collected using structured questionnaires. Direct stool microscopic examination and modified Zeihl–Neelsen staining technique to identify parasites. Chi-square test was conducted to determine the real predictors of the infection. Significant association was considered when p-value <0.05 at 95% CI.

Results

The overall magnitude of intestinal parasitic infections among the study population was 16.9% (95% CI: 13.0–20.8%). The most predominant parasitic infections were Cryptosporidium spp. (9.6%) and the least was Taenia spp. (0.78%). Diarrheal status (χ²=7.653, df=2, p=0.022) was detected to be the only significant associated variable.

Conclusion

Cryptosporidium infection was found to be the most common intestinal parasitosis among HIV-infected children. Routine screening service for Cryptosporidium and other intestinal parasites is important in the clinical management of HIV-infected children.

Keywords:

• intestinal parasites
• Cryptosporidium
• HIV/AIDS
• Southern Ethiopia

Acknowledgments

We would like to thank Hawassa University, HU-CSH laboratory staff, ART clinic staff, and the study subjects, parents, and children.

We would like to thank also Mrs Sally Callihan and Dr Donald Callihan (bacteriologists) from the USA for language editing.

An abstract of this paper was presented at the International Workshop on Microbiome in HIV Pathogenesis, Prevention, and Treatment as a poster presentation with interim findings. The poster’s abstract was published in “Poster Abstracts” Virology Education (https://virology.eventsair.com/QuickEventWebsitePortal/microbiomeinhiv2019/program/Agenda/AgendaItemDetail?id=7dc53cfc-a1a4-4cf3-a6de-106f35fd3a1b).

Ethical Clearance

The Institutional Review Board of the College of Medicine and Health Sciences, Hawassa University approved the study. Involvement was voluntary and informed written consent was obtained from caregivers of the study participants. Physicians managed those found to be infected with any pathogenic intestinal parasites. This study was conducted in accordance with the declaration of Helsinki.

Availability Of Data And Material

All the raw data supporting the findings can be obtained from all authors.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The study was partially sponsored by Hawassa University for data collection and laboratory diagnosis.