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Title: Gut parasites in HIV-seropositive Zambian adults with diarrhoea.
Author: Khumalo-Ngwenya B, Luo NP, Chintu C, Sunkutu R, Sakala-Kazembe F, Baboo KS, Mathewson J, Zumla A.
Journal: East Afr Med J; 1994 Jun; 71(6):379-83. PubMed ID: 7835260.
Abstract:
We undertook a nine month study to define the frequency of parasitic infections in adults with diarrhoea presenting at the medical filter clinic and the Dermatovenereology clinic of the University Teaching Hospital in Lusaka, Zambia. A total of 287 patients with diarrhoea were enrolled in the study; 130 from the adult medicine filter clinic recruitment consulting room and 157 patients from the Dermatovenereology clinic. Of 130 patients from the adult filter clinic, 85 (65%) were HIV-seropositive and 45 (35%) were seronegative for HIV. Out of 85 HIV-seropositive patients, 58 (68.2%) had acute diarrhoea and 27 (31.8%) had chronic diarrhoea. Of the 45 HIV-seronegative patients, 35 (77%) had acute diarrhoea and 10 (23%) had chronic diarrhoea. All of the 157 patients recruited from the Dermatovenereology clinic were HIV-seropositive. Of these, 97 (62%) had chronic diarrhoea; 7 (4%) had acute diarrhoea, and 53 (34%) patients had no diarrhoea. The common parasites detected were Ascaris lumbricoides, hookworm, Entamoeba coli, and Cryptosporidium spp. Isospora belli and Cryptosporidium spp were seen only in the HIV-seropositive group. In the Dermatovenereology clinic there was a statistically significant difference between parasite detection rate of Isospora belli and Cryptosporidium spp in HIV-seropositive patients with chronic diarrhoea compared to asymptomatic HIV-seropositive individuals P < 0.01 and p = 0.05, respectively). A significant difference in detection rates of Entamoeba coli was seen between the HIV-seropositive group in the Dermatovenereology clinic [17 (10.8%) out of 157] compared to 1 (1.5%) out of 85 in the adult medicine filter clinic.(ABSTRACT TRUNCATED AT 250 WORDS) Over a period of 9 months (June 1, 1992-February 25, 1993), a total of 287 patients with diarrhea presenting at the adult medicine filter clinic (130) and the dermatovenereology clinic (157) of the University Teaching Hospital in Lusaka, Zambia, were enrolled in a study of the frequency of parasitic infections in adults with diarrhea. All of the 157 patients recruited from the dermatovenereology clinic were HIV-seropositive. Of these, 97 (62%) had chronic diarrhea; 7 (4%) had acute diarrhea, and 53 (34%) had no diarrhea. Out of 130 patients recruited from the adult medicine filter clinic, 85 (65.4%) were HIV-seropositive and 45 (34.6%) were seronegative. Of the HIV-seropositive patients, 58 (68%) had acute diarrhea and 27 (32%) had chronic diarrhea. 10 (23%) of the HIV-seronegative patients had chronic diarrhea. The common parasites detected in stools of all HIV-seropositive adults were Ascaris lumbricoides, hookworm, Entamoeba coli, and Cryptosporidium spp. The coccidian parasites Isospora belli and Cryptosporidium spp were seen only in the HIV-seropositive group. In the dermatovenereology clinic there was a statistically significant difference between parasite detection rate of Isospora belli and Cryptosporidium spp in HIV-seropositive patients with chronic diarrhea compared to asymptomatic HIV-seropositive individuals (p = 0.01 and p 0.05, respectively). Cryptosporidium was detected in 4 (4.7%) HIV-seropositive adults in the adult medicine filter clinic and in 4 (4%) seropositive patients with diarrhea in the dermatovenereology clinic. Isospora belli was detected in 5 (6%) HIV-seropositive adult medicine filter clinic patients, while 9 (9%) HIV-seropositive patients from the dermatovenereology clinic had this parasite. A significant difference in detection rates of Entamoeba coli was seen between the HIV-seropositive group in the dermatovenereology clinic: 17 (10.8%), compared to patients in the adult medicine filter clinic: 1 (1.5%).

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