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
No Thumbnail Available
Date
2014-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: Intestinal parasites (IPs) are major concerns in most developing countries where
HIV/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 to
suffer 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) between
August 05, 2013 and September 25, 2013. A total of 180 (79 HAART initiated and 101 non-HAART
initiated) children were selected by using consecutive sampling. Stool specimen was collected and
processed using direct wet mount, formol-ether concentration and modified Ziehl-Neelson staining
techniques. A structured questionnaire was used to collect data on Socio-demographic and associated
risk 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% of
non-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 associated
with lower CD4+ T cell counts <350 cells/μL or 25% in non-HAART patients. The overall
prevalence of anemia was 10% in HAART and 31.7% in non-HAART groups. Intestinal parasitic
infection (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 with
anemia in non-HAART patients. The prevalence of IPs in non-HAART patients was significantly
associated with Eating unwashed/raw fruit [AOR, 95%CI: 6.3(1.2, 25.6), P<0.05], open field
defecation [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 with
abdominal pain [AOR, 95%CI: 21(3.7, 121)] in both groups.
Conclusion: The overall prevalence of intestinal parasites (IPs) differed by HAART status and
cryptosporidium 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 study
identified some environmental and associated risk factors for intestinal parasitic infections.
Therefore, Public health measures should continue to emphasize the importance of environmental
and personal hygiene to protect infections with intestinal parasites and maximize the benefits of
highly active anti-retroviral therapy (HAART
Description
Keywords
CD4+T Cells, HAART Initiated, Non-HAART Initiated