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Intestinal Parasitoses in HIV Infected Children in a Nigerian Tertiary Hospital
Olusola Adetunji Oyedeji1, Ebun Adejuyigbe2, Samuel Olorunyomi Oninla1
1Consultant Paediatrician, Department of Paediatrics, LAUTECH Teaching Hospital , Osogbo, Osun State, Nigeria .
Insights
Cryptosporidial infection is the most common intestinal parasite in HIV-infected children in Nigeria. Treatments like anti-helminthics, co-trimoxazole, and antiretroviral therapy show protective effects against this infection.
Area of Science:
- Pediatric Infectious Diseases
- HIV/AIDS Research
- Global Health
Background:
- Intestinal parasitic infections are prevalent in developing countries, disproportionately affecting children's health and growth.
- Limited data exists on the co-occurrence of HIV and intestinal parasites in African pediatric populations.
Purpose of the Study:
- To identify intestinal parasites in HIV-infected children in Nigeria.
- To characterize HIV-infected children attending a Nigerian teaching hospital.
Main Methods:
- A cohort of 52 children from a Pediatric anti-retroviral clinic was studied.
- Clinical data and socio-demographics were collected; stool samples were analyzed for parasites.
- Statistical analysis was performed using SPSS 18 software.
Main Results:
- Cryptosporidium spp. infected 19.2% of children, while Ascaris lumbricoides infected 1.9%.
- Previous anti-helminthic use, co-trimoxazole prophylaxis, and highly active antiretroviral therapy (HAART) were associated with reduced Cryptosporidium prevalence.
- Children with Cryptosporidium infection had a significantly higher incidence of recurrent abdominal pain (RR=5.6).
Conclusions:
- Cryptosporidial infection is the predominant intestinal parasite in this cohort of HIV-infected children.
- Anti-helminthics, co-trimoxazole, and HAART demonstrate a protective effect against intestinal Cryptosporidium.
- Screening for intestinal Cryptosporidium is recommended for HIV-infected children presenting with recurrent abdominal pain.
Background:
Intestinal parasitoses are common amongst people living in developing countries. They may impact negatively on the growth and health of immune competent children. There is paucity of information on the association between HIV and intestinal parasitoses in African children.
Objective:
To identify the intestinal infections responsible for infections in HIV infected children and document characteristics of HIV infected children at a Nigerian teaching hospital.
Materials And Methods:
Consecutive children attending a Paediatric anti-retroviral clinic were studied. Information such as socio-demographics and clinical characteristics elicited from clinical examination were recorded in the proforma. Stool samples of the children were obtained and examined for intestinal parasites. Data was analysed with the SPSS 18 software.
Results:
A total 52 children were studied and their age ranged between 6 months and 14 years, with a mean of 6.5 years ± 3.93. The 52 were made up of 27 boys and 25 girls, giving a male: female ratio of 1.1:1. 10 (19.2%) of the 52 children were infected with cryptosporidium spp, while 1(1.9%) had Ascaris lumbricoides infestation. Anti-helminthics had previously been administered to 86.5% of children studied. Those who previously received anti-helminthics had lower prevalence estimates of cryptosporidium infections. (p<0.01, RR = 0.42, 95%CI = 0.20 - 0.90). Children on co-trimoxazole prophylaxis had lower prevalence estimates of cryptosporidium infections. (P<0.01, RR = 0.35, 95%CI = 0.14 - 0.91). Use of highly active antiretroviral drugs was also associated with lower prevalence estimates of intestinal cryptosporidium. (p=0.04, RR = 0.58, 95%CI = 0.31 - 1.10). Eight of the 10 children infected with cryptosporidium had recurrent abdominal pain in comparison with the six with recurrent abdominal pain amongst the 42 without cryptosporidial infections. (p<0.01, RR=5.6, 95%CI= 2.51 - 12.1).
Conclusion:
Cryptosporidial infection is the most common intestinal parasitoses among HIV infected children in this study, while intestinal helminthiasis are not so common. Anti-helminthics, Co-trimoxazole prophylaxis and highly active anti-retroviral therapy have a protective effect against intestinal cryptosporidium. Screening for intestinal cryptosporidium is suggested in HIV infected children with recurrent abdominal pain, because of the statistically association.
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