埃塞俄比亚北部德布雷塔博尔综合医院接受抗逆转录病毒治疗的艾滋病毒感染患者的肠道寄生虫感染：一项横断面研究
Intestinal Parasitic Infections among HIV-Infected Patients on Antiretroviral Therapy Attending Debretabor General Hospital, Northern Ethiopia: A Cross-Sectional Study.
作者信息
Alemayehu Ermias, Gedefie Alemu, Adamu Aderaw, Mohammed Jemal, Kassanew Brhanu, Kebede Berhanu, Belete Melaku Ashagrie
机构信息
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia.
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia.
出版信息
HIV AIDS (Auckl). 2020 Oct 28;12:647-655. doi: 10.2147/HIV.S275358. eCollection 2020.
BACKGROUND
Parasitic infections are known causes of morbidity among HIV-infected patients with low CD4 counts who are on antiretroviral therapy (ART), mainly as a result of immuno suppression. This study aimed to assess the extent of intestinal parasitic infection and related risk factors among HIV-infected patients attending ART clinic at Debretabor General Hospital, Northern Ethiopia.
METHODS
A health facility-based cross-sectional study was conducted on 383 HIV-infected patients attending the ART clinic of Debretabor General Hospital, northern Ethiopia from December 2018 to March 2019. An interview-based structured questionnaire was used to gather sociodemographic and risk-factor data. About 5 g fresh stool and 4 mL venous blood were collected from each patient, then transported and tested in accordance with laboratory-standard operating procedures. Data obtained were entered into SPSS version 22.0 and analyzed. <0.05 with 95% CI was considered statistically significant.
RESULTS
The overall prevalence of intestinal parasites was 25.3%, with 18% and 23.8% by direct wet-mount and formol ether-concentration technique, respectively. Eight (2.1%) patients were infected by multiple parasites using the concentration technique. was the most frequently identified parasite (n=23, 25.3%). Parasitic infection was significantly higher among illiterates (0.011), patients with CD4 count <200 cells/mm (<0.001), and those who did not have a toilet in their home (0.049) than their counterparts.
CONCLUSION
Relatively higher prevalence of intestinal parasitic infection was found among HIV/AIDS patients. The distribution of intestinal parasites was greatly affected by illiteracy, reduced CD4 counts, and absence of a toilet. Therefore, HIV/AIDS patients with low CD4 counts should be diagnosed consistently for intestinal parasites with routine stool examinations, and awareness creation should be advocated to be included as an essential component of ART-monitoring strategies for improved patient care.
背景
寄生虫感染是接受抗逆转录病毒治疗（ART）且CD4细胞计数较低的HIV感染患者发病的已知原因，主要是免疫抑制的结果。本研究旨在评估埃塞俄比亚北部德布雷塔博尔综合医院接受ART治疗的HIV感染患者肠道寄生虫感染的程度及相关危险因素。
方法
2018年12月至2019年3月，对埃塞俄比亚北部德布雷塔博尔综合医院ART门诊的383例HIV感染患者进行了一项基于医疗机构的横断面研究。采用基于访谈的结构化问卷收集社会人口学和危险因素数据。从每位患者收集约5克新鲜粪便和4毫升静脉血，然后按照实验室标准操作程序进行运输和检测。将获得的数据录入SPSS 22.0版进行分析。P<0.05且95%置信区间被认为具有统计学意义。
结果
肠道寄生虫的总体感染率为25.3%，直接涂片法和甲醛乙醚浓缩法的感染率分别为18%和23.8%。采用浓缩法，8例（2.1%）患者感染了多种寄生虫。蛔虫是最常检出的寄生虫（n=23，25.3%）。文盲患者（P=0.011）、CD4细胞计数<200个/立方毫米的患者（P<0.001）以及家中没有厕所的患者（P=0.049）的寄生虫感染率显著高于对照组。
结论
HIV/AIDS患者肠道寄生虫感染率相对较高。文盲、CD4细胞计数降低和没有厕所对肠道寄生虫的分布有很大影响。因此，应定期对CD4细胞计数低的HIV/AIDS患者进行肠道寄生虫常规粪便检查诊断，并倡导开展提高认识活动，将其作为改善患者护理的ART监测策略的重要组成部分。
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