Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
AIDS Res Ther. 2013 Feb 25;10(1):7. doi: 10.1186/1742-6405-10-7.
Intestinal parasites are a major concern in most developing countries where HIV/AIDS case are concentrate and almost 80% of AIDS patients die of AIDS-related infections. In the absence of ART, HIV/AIDS patients in developing countries unfortunately continue to suffer from the consequences of opportunistic parasites. But this prevalence has dramatically decreased in countries where antiretroviral agents are widely available. Therefore, the aim of this study was to assess the prevalence of intestinal parasite and risk factor among pre- ART and on ART adult HIV/ AIDS patients attending ART clinic in Dessie hospital.
A comparative cross-sectional study was conducted among pre-ART and on ART adult HIV/AIDS patients of Dessie Hospital. A total of 272 (136 from each group) study subjects were selected by using systematic random sampling. Stool sample was collected and processed using direct wet mount, formol-ether concentration technique and modified Ziehl-Neelson staining techniques. A structured questionnaire was used to collect data on Sociodemographic & associated risk factors. Data was entered and analyzed by using SPSS 16 software and logistic regressions were applied to assess any association between explanatory factors and outcome variables.
The overall prevalence of IP in pre-ART and on-ART was 39% and 17.6%, respectively with significant decrease of intestinal parasite in the ART era (p < 0.001). All Cryptosporidium spps infections were found in the pre-ART patients and significantly associated for lower CD4 <200cells/mm3. Absence of toilet (AOR = 7.57; 95% CI = 1.3,44.22), source of water (AOR = 6.03; 95% CI = 1.14,31.98), living condition (AOR = 13.29, 95% CI = 5.14, 34.35); WHO stage (AOR = 6.06; 95% CI = 2.49,14.74) and ART status (AOR = 7.55; 95% CI = 3.24,17.59) have significant association with prevalence of intestinal parasite.
The overall prevalence of IP was differ by ART status and opportunistic parasite like cryptosporidium spps were found in low CD4 counts in ART naive patients. This study identified some environmental and some clinical finding as determinant factor for IP infections. Therefore, public health measures and adherence to ART should be strengthened to improve the quality of life of these patients.
肠道寄生虫是大多数发展中国家的一个主要问题，这些国家集中了艾滋病毒/艾滋病病例，几乎 80%的艾滋病患者死于艾滋病相关感染。在没有抗逆转录病毒药物治疗（ART）的情况下，发展中国家的艾滋病毒/艾滋病患者不幸继续遭受机会性寄生虫的后果。但在广泛提供抗逆转录病毒药物的国家，这种流行率已显著下降。因此，本研究旨在评估在德西医院接受抗逆转录病毒治疗的成年艾滋病毒/艾滋病患者在接受抗逆转录病毒治疗前（ART）和接受抗逆转录病毒治疗时肠道寄生虫的流行率和危险因素。
对德西医院接受抗逆转录病毒治疗前和接受抗逆转录病毒治疗的成年艾滋病毒/艾滋病患者进行了一项比较性横断面研究。采用系统随机抽样方法选取了 272 名（每组 136 名）研究对象。采集粪便样本，采用直接湿片、甲醛乙醚浓缩技术和改良齐尔-尼尔森染色技术进行处理。采用结构化问卷收集社会人口统计学和相关危险因素数据。数据输入并使用 SPSS 16 软件进行分析，并应用逻辑回归评估解释因素与结局变量之间的任何关联。
接受抗逆转录病毒治疗前和接受抗逆转录病毒治疗的患者肠道寄生虫总流行率分别为 39%和 17.6%，抗逆转录病毒治疗时代肠道寄生虫显著减少（p<0.001）。所有隐孢子虫属感染均发生在接受抗逆转录病毒治疗前的患者中，且与 CD4<200 个细胞/mm3 显著相关。没有厕所（AOR=7.57；95%CI=1.3，44.22）、水源（AOR=6.03；95%CI=1.14，31.98）、生活条件（AOR=13.29，95%CI=5.14，34.35）；世界卫生组织（WHO）分期（AOR=6.06；95%CI=2.49，14.74）和抗逆转录病毒治疗状态（AOR=7.55；95%CI=3.24，17.59）与肠道寄生虫的流行率有显著关联。
肠道寄生虫的总流行率因抗逆转录病毒治疗状态而异，在接受抗逆转录病毒治疗前的患者中，低 CD4 计数时会发现隐孢子虫属等机会性寄生虫。本研究确定了一些环境和临床发现是肠道寄生虫感染的决定因素。因此，应加强公共卫生措施和抗逆转录病毒治疗的依从性，以提高这些患者的生活质量。
