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Intestinal parasites in HIV-seropositive Zambian children with diarrhoea
1Department of Paediatrics & Child Health, University Teaching Hospital, Lusaka, Zambia.
Insights
Parasitic infections are common in hospitalized children with diarrhea in Zambia. HIV-seropositive children with chronic diarrhea showed higher rates of Cryptosporidium infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Tropical Medicine
Background:
- Diarrhea is a significant health concern in hospitalized children.
- Parasitic infections contribute to childhood morbidity, particularly in resource-limited settings.
- Human Immunodeficiency Virus (HIV) serostatus may influence the susceptibility and course of parasitic infections in children.
Purpose of the Study:
- To determine the frequency of intestinal parasitic infections in hospitalized children aged 15 months to 5 years with diarrhea.
- To investigate the association between parasitic infections and HIV serostatus in this pediatric population.
- To explore correlations between parasite isolation and clinical characteristics like diarrhea type (acute vs. chronic).
Main Methods:
- A 9-month prospective study was conducted at the University Teaching Hospital in Lusaka, Zambia.
- Mothers of children admitted with diarrhea were interviewed every alternate day for enrollment.
- Stool samples were analyzed to identify intestinal parasites in 178 enrolled children, categorized by HIV status and diarrhea type.
Main Results:
- At least one intestinal parasite was detected in 34% of the 178 children studied.
- Ascaris and Cryptosporidium were the most frequently identified parasites.
- Cryptosporidium spp. was significantly more prevalent in HIV-seropositive children (14%) compared to HIV-seronegative children (6%) (P=0.01).
- HIV-seropositive children with chronic diarrhea exhibited higher rates of Cryptosporidium isolation (21%) than those with acute diarrhea (5%) (P>=0.01).
Conclusions:
- Parasitic infections are a notable cause of diarrhea in hospitalized children in Lusaka, Zambia.
- HIV-seropositive children are at increased risk for Cryptosporidium infections, especially with chronic diarrhea.
- These findings highlight the importance of parasitic infection screening and management in immunocompromised children presenting with diarrhea.
Abstract:
We undertook a study over a period of 9 months to define the frequency of parasitic infections in hospitalized children with diarrhoea between the ages of 15 months and 5 years. Every alternate day, mothers of all children admitted with diarrhoea between 09.00 hours and 12.00 hours to one of the wards of the Department of Pediatrics and Child Health of the University Teaching Hospital (UTH) in Lusaka, Zambia, were interviewed for enrollment of their children into the study. A total of 178 children with diarrhoea were enrolled in the study. Of these 44 (25 per cent) were HIV seropositive and 134 (75 per cent) were seronegative for HIV. Out of 44 HIV-seropositive patients, 20 (45 per cent) had acute diarrhoea and 24 (55 per cent) had chronic diarrhoea. Of the 134 HIV-seronegative patients, 68 had acute diarrhoea (51 per cent) and 66 (49 per cent) had chronic diarrhoea. At least one intestinal parasite was found in 34 out of the 178 children enrolled. The commonest parasites identified were Ascaris and Cryptosporidia. No associations were identified between parasite isolation and the following: age, sex, or socio-economic status. Cryptosporidium spp. was isolated from 6 out of 44 (14 per cent) HIV-seropositive children, while 8 out of 134 (6 per cent) seronegative children had the parasite (P = 0.01). HIV-seropositive children with chronic diarrhoea had significantly higher cryptosporidium identification rates than those HIV-seropositive children with acute diarrhoea [5 out of 24 (21 per cent) patients with chronic diarrhoea compared to 1 out of 20 (5 per cent) patients with acute diarrhoea; (P > or = 0.01)].(ABSTRACT TRUNCATED AT 250 WORDS)