Epidemiology of Coccidian Parasites in HIV Patients of Northern Uganda
Isaac Echoru *
Department of Anatomy, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Bushenyi, Uganda and Department of Medical Laboratory Sciences, Faculty of Medicine, Mbarara University of Science and Technology, Uganda.
Lule Herman
Department of Surgery, Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, Bushenyi, Uganda.
Lisa Micheni
Department of Microbiology, Faculty of Biomedical Sciences, Kampala International University Western Campus, Bushenyi, Uganda.
Mulkah O. Ajagun-Ogunleye
Department of Biochemistry, Faculty of Biomedical Sciences, Kampala International University Western Campus, Bushenyi, Uganda.
Muhamudu Kalange
Department of Physiology, Faculty of Biomedical Sciences, Kampala International University Western Campus, Bushenyi, Uganda.
Keneth Iceland Kasozi
Department of Physiology, Faculty of Biomedical Sciences, Kampala International University Western Campus, Bushenyi, Uganda.
*Author to whom correspondence should be addressed.
Abstract
Aim: The epidemiology of coccidian parasites in HIV patients of sub-sahara Africa is poorly understood. This study aimed at determining the epidemiology of coccidian parasites and their associated risk factors. This was a cross sectional study carried out in Arua district in West Nile region of Northern Uganda for a period of five months.
Materials and Methods: Participants in the study included HIV positive patients presenting with diarrhea. A total of 111 patients were included and classified into children, middle aged and adults. A structured questionnaire was administered, stool samples were obtained using sterile stool containers and laboratory analysis carried out using modified Ziehl-Neelsen technique (ZN). Ethical clearance was acquired and the consent of the patients was sought.
Results and Discussion: Prevalence of Coccidian parasites among HIV patients was found to be 5.4% and Cryptosporidium parvum showed more prevalence than Isospora belli and Cyclospora cayatenensis i.e. (3.6%), (1.8%) and (0.0%) respectively. Most Cryptosporidium parvum infections occurred in children (13.6%) compared to adults (3.3%); with a significant relationship of (p = 0.02). The infection was higher in females (7.1%) than males (2.4%) (p = 0.19). The major risk factors associated with the disease were mainly consumption of contaminated and un-boiled water from taps and boreholes.
HIV patients who took co-trimoxazole and drunk boiled water were shown to have a low prevalence of coccidian parasites of 1.9% and 2.6% respectively (p<0.05). This is because co-trimoxazole is a prophylactic drug for opportunistic infections and proper boiling of drinking water kills coccidian parasites.
Conclusion and Recommendations: The study highlighted the importance and need to screen for coccidian parasites and emphasis on regular taking of prophylactic treatment as a way of controlling opportunistic infections in HIV patients. Future prevalence studies of Coccidia amongst healthy, HIV sero-negative children and adults of similar age groups in similar settings are recommended to ratify the relationship.
Keywords: “Epidemiology of coccidia in humans;”, “coccidiain HIV patients;”, “coccidiarisk factors;”, “cryptosporidium in Uganda;”, “diarrhea in HIV patients.”