Department of Veterinary Public Health and Preventive Medicine, University of Jos, PMB 2086, Jos, Nigeria.
Department of Parasitology and Entomology, Modibbo Adama, University of Technology, Yola, Adamawa State, Nigeria.
Acta Parasitol. 2021 Mar;66(1):60-74. doi: 10.1007/s11686-020-00253-8. Epub 2020 Jul 18.
Cryptosporidium is implicated in diarrhea epidemics in many parts of the world and is said to be the most common protozoan cause of diarrhea among people living with HIV/AIDS (PLWHA) globally. To provide data on the burden of Cryptosporidium infections among Nigerians living with HIV/AIDS, we reported the prevalence, geographic distribution and Cryptosporidium species diversity among this population in Nigeria.
We used the PRISMA guidelines to perform a systematic review and meta-analysis of articles published between January 1, 1995 and April 21, 2020. Pooled estimate (PE), heterogeneity, quality of each study and publication bias were determined using the random-effects model, Cochran's Q test, the 9 point Joanna Briggs Institute Critical Appraisal Instrument and the Egger's regression asymmetry test, respectively.
Forty-six articles reported 2612 positive cases of Cryptosporidium infections from 12,756 PLWHA examined in 20 Nigerian States and the Federal Capital Territory. Overall pooled estimate was 14.5% (95% CI 10.4-19.9) with a range of 0.3% (95% CI 0.0-1.8) to 43.7% (95% CI 35.6-52.3) across sub-groups, with the PEs in relation to CD4 T cell count, species and age showing significant variations at p < 0.05. Cryptosporidium hominis was the most prevalent (3.5%, 95% CI 2.3-5.2) of the six Cryptosporidium species reported in Nigeria.
Cryptosporidium infections are moderately prevalent among PLWHA in Nigeria with the highest regional prevalence in the north-east. In addition to personal hygienic practices, the inclusion of Cryptosporidium screening as part of HIV/AIDS clinics in Nigeria will reduce the burden of the parasite among PLWHA in Nigeria.
隐孢子虫在世界许多地区的腹泻流行中被牵涉，据称是全球 HIV/AIDS 患者（PLWHA）中最常见的原生动物腹泻病因。为了提供尼日利亚 HIV/AIDS 患者中隐孢子虫感染负担的数据，我们报告了该人群中隐孢子虫感染的流行率、地理分布和种属多样性。
我们使用 PRISMA 指南对 1995 年 1 月 1 日至 2020 年 4 月 21 日期间发表的文章进行了系统评价和荟萃分析。使用随机效应模型、Cochran's Q 检验、9 分 Joanna Briggs 研究所批判性评价工具和 Egger 的回归不对称检验分别确定汇总估计值（PE）、异质性、每项研究的质量和发表偏倚。
46 篇文章报告了来自尼日利亚 20 个州和联邦首都地区的 12756 名 PLWHA 中 2612 例隐孢子虫感染阳性病例。总体汇总估计值为 14.5%（95%CI 10.4-19.9），范围为 0.3%（95%CI 0.0-1.8）至 43.7%（95%CI 35.6-52.3），在亚组之间，PE 与 CD4 T 细胞计数、种属和年龄有关的结果存在显著差异（p<0.05）。在尼日利亚报告的六种隐孢子虫中，隐孢子虫 hominis 是最常见的（3.5%，95%CI 2.3-5.2）。
在尼日利亚的 PLWHA 中，隐孢子虫感染率中等，东北部地区的区域性流行率最高。除了个人卫生习惯外，在尼日利亚的 HIV/AIDS 诊所中将隐孢子虫筛查纳入其中，将减少尼日利亚 PLWHA 中寄生虫的负担。
