Background There are little data on the prevalence and clinical outcomes of coccidian parasites infection in HIV positive patients in Africa.
Methods We conducted a cross-sectional study at the Opportunistic Infections Clinic of the Provincial Hospital of Bukavu, from April 2010 to October 2011. HIV patients attending the clinic, aged 15 years and above were included after obtaining their consent, the CD4 count and patient details were recorded, stool samples were collected according to the WHO procedure. A single stool sample was collected and conserved in formalin - ether 10% and transported to the Provincial Laboratory of Bukavu for analysis. A consecutive sample of 108 patients was collected.
Smears were stained according to the modified ziehl neelsen procedure and examined at x100 magnification using an oil immersion microscope. Data were analysed with EPI-INFO 3.5. Differences with P-values < 0.05 were considered significant.
Results 58.3% were female. Mean (±SD) age 40 ± 15.7 years old. Stools were diarrheic in 66.7%. Overall prevalence of Cryptosporidium spp was 57.9% (95% CI: 41.8 – 76.1), Cyclospora cayetanensis 31.6% (95% CI: 19.3 – 47.5). 63.9% of patients were on antiretroviral therapy. Patients with CD4 counts < 50cells/μL, presented with a higher prevalence of either Cryptosporidium spp (62.1%) or Cyclospora cayetanensis (27.6%) (P = 0.0000). In diarrheic stools we recorded 59.6% (28/47) Cryptosporidium spp (P = 0.0001), 27.7% (13/47) Cyclospora cayetanensis. Dual infections were more noted in the CD4 count range of < 100 cells/μL, 63.4% (26/41) for CD4 count < 50cells/μL and 36.6% (15/41) for CD4 50 – 100cells/μL (P = 0.0000). On ARV, only subjects with100 – 200 cells/μL of CD4, had a good clinical evolution (P = 0.0000).
Conclusions Cryptosporidium parvum and Cyclospora cayetanensis are highly prevalent in HIV patients with advanced diseases and major causes of chronic diarrhoea. Dual infection is related to very low CD4 count.
- HIV KL01,
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