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Detection of microsporidia in local HIV-positive population in Malaysia
Angela Lono1, Suresh Kumar, Tan Tian Chye
1Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur.
Abstract:
The HIV-positive population, due to their immuno-compromised nature, is considered more susceptible to parasitic infections than other populations. However despite the reports of other opportunistic pathogens such as Cryptosporidium and tuberculosis reported in vulnerable communities, microsporidia have not been highlighted in the local HIV-positive population in Malaysia. This study aimed to provide preliminary information on the prevalence of microsporidia in the local HIV-population. Microsporidia were detected in 21/247 (8.5%) stool samples from the HIV-infected individuals, a significantly higher (P-value <0.05) prevalence than in the control group, in which 5/173 (2.9%) were positive. HIV patients were 3x more at risk for acquiring microspordium (OR: 3.12; 95% CI 1.15-8.44). Spores were ellipsoid in shape with outlines that stained dark pink with the interior a lighter shade. Approximately 21% of the positive specimens were from individuals in the 40-49 years age group. Ten individuals who were positive for microsporidia were also positive for other enteric parasites such as Blastocystis hominis and Giardia lamblia. We detected Encephalitozoon intestinalis DNA following nested PCR from three of 10 samples analysed, as demonstrated by an amplicon of 370bp. From the findings reported, it appears that microsporidial infection in humans may actually be more common than reported. We strongly advocate greater emphasis on personal hygiene through public education on personal hygiene and the consumption of boiled or filtered water.
Insights
Microsporidia infections are more common in HIV-positive individuals in Malaysia. Enhanced hygiene and water filtration are recommended to reduce the spread of these parasitic infections.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Public Health
Background:
- The Human Immunodeficiency Virus (HIV)-positive population is immunocompromised, increasing susceptibility to opportunistic parasitic infections.
- While other opportunistic pathogens are documented, microsporidia prevalence in Malaysia's HIV-positive demographic remains under-reported.
Purpose of the Study:
- To determine the prevalence of microsporidia in HIV-positive individuals in Malaysia.
- To compare microsporidia prevalence between HIV-positive patients and a control group.
- To identify risk factors and co-infections associated with microsporidiosis in this population.
Main Methods:
- Stool samples were collected from HIV-infected individuals and a control group.
- Microsporidia were detected using microscopy.
- Nested Polymerase Chain Reaction (PCR) was employed to detect Encephalitozoon intestinalis DNA.
Main Results:
- Microsporidia were detected in 8.5% of HIV-positive individuals versus 2.9% in the control group (P<0.05).
- HIV patients showed a 3-fold increased risk (OR: 3.12) of microsporidial infection.
- Encephalitozoon intestinalis DNA was identified in 30% of tested positive samples; co-infections with Blastocystis hominis and Giardia lamblia were observed.
Conclusions:
- Microsporidial infections may be more prevalent in HIV-positive individuals than previously recognized in Malaysia.
- Findings highlight the need for increased diagnostic focus on microsporidia in immunocompromised patients.
- Public health education emphasizing personal hygiene and safe water consumption is crucial for prevention.
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