Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA.
Trans R Soc Trop Med Hyg. 2013 Oct;107(10):631-8. doi: 10.1093/trstmh/trt078.
Diarrhoea is a significant cause of morbidity and mortality in immunocompromised patients. The objectives of this study were to investigate the aetiological agents, risk factors and clinical features associated with diarrhoea in HIV/AIDS patients in Kenya.
Sociodemographic, epidemiological and clinical data were obtained for 164 HIV/AIDS patients (70 with and 94 without diarrhoea) recruited from Kenyatta National Hospital, Kenya. Stool samples were examined for enteric pathogens by microscopy and bacteriology.
Intestinal protozoa and fungi were identified in 70% of patients, more frequently in those with diarrhoea (p<0.001). Helminths were detected in 25.6% of patients overall, and bacterial pathogens were identified in 51% of patients with diarrhoea. Polyparasitism was more common in patients with diarrhoea than those without (p<0.0001). Higher CD4(+) T-cell count (OR = 0.995, 95% CI 0.992-0.998) and water treatment (OR = 0.231, 95% CI 0.126-0.830) were associated with a lower risk of diarrhoea, while close contact with cows (OR = 3.200, 95% CI 1.26-8.13) or pigs (OR = 11.176, 95% CI 3.76-43.56) were associated with a higher risk of diarrhoea.
Multiple enteric pathogens that are causative agents of diarrhoea were isolated from stools of antiretroviral therapy-naïve HIV/AIDS patients, indicating a need for surveillance, treatment and promotion of hygienic practices.
腹泻是免疫功能低下患者发病率和死亡率的重要原因。本研究旨在调查肯尼亚艾滋病毒/艾滋病患者腹泻的病因、危险因素和临床特征。
从肯尼亚肯雅塔国家医院招募了 164 名艾滋病毒/艾滋病患者（70 名腹泻患者和 94 名无腹泻患者），收集了他们的社会人口统计学、流行病学和临床数据。通过显微镜和细菌学检查粪便样本以检测肠道病原体。
肠道原虫和真菌在 70%的患者中被发现，腹泻患者中更常见（p<0.001）。寄生虫在所有患者中的检出率为 25.6%，腹泻患者中细菌病原体的检出率为 51%。腹泻患者的寄生虫感染更为常见（p<0.0001）。较高的 CD4+T 细胞计数（比值比[OR] = 0.995，95%置信区间[CI] 0.992-0.998）和水的处理（OR = 0.231，95% CI 0.126-0.830）与腹泻风险降低相关，而与奶牛（OR = 3.200，95% CI 1.26-8.13）或猪（OR = 11.176，95% CI 3.76-43.56）密切接触与腹泻风险增加相关。
从接受抗逆转录病毒治疗的艾滋病毒/艾滋病患者的粪便中分离出多种引起腹泻的肠道病原体，这表明需要进行监测、治疗和促进卫生习惯。
