Epidemiology of Coccidian Parasites in HIV Patients of Northern Uganda

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 cotrimoxazole 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.