*[1]Aniobi, C. C., and [2]Onyemelukwe, N. F.
1Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
2Department of Medical Laboratory Science, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
*Correspondence to: ccaniobi@gmail.com; 08036979635
Abstract:
Background: Intestinal parasites in HIV/AIDS patients increase the risk of gastroenteritis, adding to the complexity of the disease. The interactions of intestinal parasites are one of the factors leading to HIV replication and progression of AIDS. Chronic immunosuppression caused by HIV infection makes people vulnerable to parasitic infestations, and this is associated with a CD4+ cell count of less than 200/mm3. This
study is aimed at determining the prevalence of enteric parasitic infection among people living with HIV in southeast Nigeria.
Methodology: This was a cross-sectional study of 535 patients recruited from Government owned tertiary health institutions with HIV referral and center for HIV/AIDS management under the Presidents Emergency Plan for Aids Relief (PEPFAR) in the 5 states of southeast Nigeria (Abia, Anambra, Ebonyi, Enugu and Imo) from September 2018 to December 2023. The institutions included FMC-Umuahia, NAUTH-Nnewi, FMC-Abakaliki UNTH-Enugu and FMC-Owerri. Stool and blood samples collected from the participants were examined using standard methods for parasitological and haematological assessment according to the guidelines of the World Health Organization. Clinical and laboratory data were analysed using the statistical software INSTAT and SPSS version 22.0, with statistical significance set at p<0.05.
Results: The prevalence of intestinal parasites among the 535 patients was 43.2% (n=231). Ascaris lumbricoides followed by hookworm emerged as the most prevalent parasites identified with 33.3% (77/231) and 29.9% (69/231) respectively while Schistosoma japonicum, Trichuris trichiura, and Enterobius. vermicularis had very low prevalence of 0.9% (2/231) each. Imo State had the highest prevalence of intestinal parasitic infection (48.0%, 48/100), followed by Anambra State (46.0%, 46/100), Abia State (44.4%, 60/135), Ebonyi State (42.0%, 42/100) and Enugu State (35.0, 35/100) but the prevalence was not significantly different between the States (p=0.3870). Patients in the age groups 21-30, 31-40, 41-50 and 51-60 years had statistically significant higher prevalence and egg burden (p=0.000). The CD4+ T cell count of the participants showed a statistically significant decrease (p<0.05) as the egg burden increases.
Conclusion: In view of the high prevalence and egg burden of intestinal parasites among HIV infected patients in this study, serious efforts must be made by appropriate government authorities to institute a regular deworming process for the populace, to reduce the egg burden of intestinal parasitosis in southeast Nigeria.
Keywords: Enteric Parasite, HIV/AIDS, CD4+ T cell: egg burden, southeast Nigeria
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