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Intestinal parasites and HIV infection in Tanzanian children with chronic diarrhea
J P Cegielski1, A E Msengi, C S Dukes
1Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710.
Insights
HIV infection is common in Tanzanian children with chronic diarrhea. Specific intestinal parasites, like Blastocystis hominis, were more frequent in HIV-infected children, suggesting a link.
Area of Science:
- Pediatric Infectious Diseases
- Gastroenterology
- Immunology
Background:
- Chronic diarrhea is a significant health issue in children, particularly in resource-limited settings.
- Human Immunodeficiency Virus (HIV) infection can exacerbate diarrheal diseases and impact nutritional status in children.
- The interplay between intestinal parasites, HIV, and chronic diarrhea in pediatric populations requires further investigation.
Purpose of the Study:
- To investigate the association between specific intestinal parasites and HIV infection in Tanzanian children suffering from chronic diarrhea.
- To compare the prevalence of intestinal parasites in HIV-infected children with chronic diarrhea, HIV-uninfected children with chronic diarrhea, and healthy controls.
Main Methods:
- A prospective, cross-sectional study was conducted at Muhimbili University College of Health Sciences in Tanzania.
- Participants included children aged 15 months to 5 years with chronic diarrhea and age-matched controls.
- Data collection involved standardized history, physical examination, HIV serology, and stool parasitology.
Main Results:
- Chronic diarrhea represented a quarter of diarrheal cases in the study age group, with affected children exhibiting severe malnutrition.
- Forty percent of children with chronic diarrhea were HIV-seropositive.
- While intestinal parasites were found in approximately 50% of all groups, diarrheagenic parasites were identified in up to 40% of children with chronic diarrhea. Blastocystis hominis was exclusively detected in HIV-infected patients.
Conclusions:
- HIV infection is prevalent among children with chronic diarrhea in this Tanzanian cohort.
- Parasitic agents are likely significant contributors to chronic diarrhea in both HIV-infected and HIV-uninfected children.
- Blastocystis hominis showed a higher frequency in HIV-infected children, and severe malnutrition may have influenced observed differences.
Objective:
To determine whether specific intestinal parasites are associated with HIV infection in Tanzanian children with chronic diarrhea.
Design:
A prospective, cross-sectional study.
Setting:
Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
Subjects:
All children aged 15 months to 5 years admitted with chronic diarrhea, and age-matched controls.
Methods:
Standardized history, physical examination, HIV serology, and stool parasitology were evaluated for all subjects. We compared three groups: HIV-infected and non-HIV-infected children with chronic diarrhea and controls without diarrhea.
Main Outcome Measures:
Fecal parasites and nutritional status.
Results:
Chronic diarrhea accounted for one-quarter of all cases of diarrheal disease in the defined age range, and children with chronic diarrhea were severely malnourished. Forty per cent of subjects with chronic diarrhea were HIV-seropositive. Although intestinal parasites were detected in approximately 50% of all three groups, diarrheagenic parasites were detected in up to 40% of children with chronic diarrhea. Blastocystis hominis was detected only in HIV-infected patients.
Conclusions:
HIV infection was common in children with chronic diarrhea, and parasitic agents of diarrhea may be important in children with chronic diarrhea both with and without HIV infection in this setting. B. hominis was more frequent in HIV-infected children. The immunocompromising effects of severe malnutrition may have diminished the difference between HIV-infected and non-HIV-infected children.