Immunologic Determinants of Intestinal Parasitic Infection among HIV/AIDS Children with Diarrhea in Aminu Kano Teaching Hospital, Kano, Nigeria.

Abstract

Abstract

Introduction: Diarrhea is a significant cause of morbidity and mortality among HIV-infected children, especially those with advanced disease. Although diarrhea among these children is caused by a multitude of factors, intestinal parasites are increasingly associated with decreasing levels of CD4+ cell count. This study aimed to determine the relationship between intestinal parasitic infections (IPIs) and immune status among HIV-infected Children in Aminu Kano Teaching Hospital.

Materials and Methods: A comparative cross-sectional study was conducted among 286 HIV-positive individuals with diarrhea and a similar number of matched HIV-negative counterparts attending AKTH. Information was collected using a semi-structured interview-administered questionnaire. Also, two stool samples (fresh and preserved with equal volume of 10% formalin) were collected from all participants; the fresh samples were immediately examined under a microscope on saline wet mount and Eosin stain preparation for motile trophozoites. The preserved samples were centrifuged, and the sediments were analyzed for parasite ova, larvae, and cysts. Oocysts of Cryptosporidium spp, Isospora, and Cyclospora were detected using the Modified Ziehl-Nielsen technique, while Microsporidia were identified using a modified trichrome stain.

Results: Significantly more intestinal parasites were found in the stool of HIV-infected children with advanced disease compared to their matched controls. Cryptosporidium parvum and Isospora belli prevalence increases with decreasing levels of CD4+ among HIV-infected children.

Conclusion: IPIs occur more frequently among those with advanced HIV disease as opportunistic infections. Efforts should be made to improve the immunity of these children to avert fatal outcomes.