Intestinal Parasitosis in Relation to CD4+T Cells Levels and Anemia among HAART Initiated and Non-HAART Initiated Pediatric HIV Patients in Zewditu Memorial Hospital, Addis Ababa, Ethiopia
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Date
2014-06
Authors
Mihiretie Hylemariam
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Publisher
Addis Ababa University
Abstract
Background: Intestinal parasites (IPs) are major concerns in most developing countries whereHIV/AIDS cases are concentrated and almost 80% of AIDS patients die of AIDS-related infections.In the absence of HAART, HIV/AIDS patients in developing countries unfortunately continue tosuffer from the consequences of opportunistic and other intestinal parasites.
Methods: A comparative cross-sectional study was conducted among HAART initiated and non-HAART initiated pediatric HIV/AIDS patients of Zewditu Memorial Hospital (ZMH) betweenAugust 05, 2013 and September 25, 2013. A total of 180 (79 HAART initiated and 101 non-HAARTinitiated) children were selected by using consecutive sampling. Stool specimen was collected andprocessed using direct wet mount, formol-ether concentration and modified Ziehl-Neelson stainingtechniques. A structured questionnaire was used to collect data on Socio-demographic and associatedrisk factors. Data were entered and analyzed using SPSS version 16 software and logistic regressions were applied to assess any association between explanatory factors and outcome variables. P values <0.05 were taken as statistically significant.
Results: The overall prevalence of IPs was 37.8% where 27.8% of HAART initiated and 45.5% ofnon-HAART initiated pediatric HIV/AIDS patients were infected with IPs (p < 0.05).Cryptosporidium species, E. histolytica/dispar, Hook worm and Taenia species were IPs associatedwith lower CD4+ T cell counts <350 cells/μL or 25% in non-HAART patients. The overallprevalence of anemia was 10% in HAART and 31.7% in non-HAART groups. Intestinal parasiticinfection (IPI) was significantly associated with anemia in non-HAART patients [AOR, 95% CI:4.5(1.3, 15.2), P< 0.05]. Hook worm, S. stercoralis and H. nana were helminthes associated withanemia in non-HAART patients. The prevalence of IPs in non-HAART patients was significantlyassociated with Eating unwashed/raw fruit [AOR, 95%CI: 6.3(1.2, 25.6), P<0.05], open fielddefecation [AOR, 95%CI: 9.3(1.6, 53.6), P<0.05] and diarrhea [AOR, 95%CI: 5.2(1.3, 21.3),P<0.05]. IPs significantly increased in rural residents [AOR, 95%CI: 0.4(0.1, 0.9)] and in those withabdominal pain [AOR, 95%CI: 21(3.7, 121)] in both groups.
Conclusion: The overall prevalence of intestinal parasites (IPs) differed by HAART status andcryptosporidium species were found only in HAART naïve patients with low CD4+ T cell counts.Anemia was also more prevalent and associated with IPs in non-HAART patients. This studyidentified some environmental and associated risk factors for intestinal parasitic infections.Therefore, Public health measures should continue to emphasize the importance of environmentaland personal hygiene to protect infections with intestinal parasites and maximize the benefits ofhighly active anti-retroviral therapy (HAART
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Keywords
CD4+T Cells HAART Initiated Non-HAART Initiated