Background: Intestinal parasitic infections are a major public health challenge in many tropical countries. Opportunistic intestinal coccidia such as Cryptosporidia, Cytoisospora or Cyclospora species are common pathogens which are regularly missed using widely practiced wet mount stool microscopy techniques. Therefore, treatment choices are limited and mostly rely on empirical use of cotrimoxazole. The aim of this study was to determine the prevalence of intestinal parasitosis among HIV-infected individuals with and without diarrhoea at the Asella Teaching and Referral Hospital in Ethiopia.
Methods: This institution-based cross sectional study was conducted among 163 ambulatory HIV-infected patients with and without diarrhoea. Stool samples were processed for both wet mount and Kinyoun stain. EDTA blood was collected for analysis of CD4 cell count using BD FACSCount™ Flow Cytometer. Sociodemographic and behavioural data was collected using a standardized questionnaire. Chi-squared test was used for statistical analysis.
Results: The majority of study participants (62.0%, n=101) were female and the mean age was 38.2 (SD +10.7) years. 52.1% (n=85) of the participants suffered from diarrhoea. The overall prevalence of intestinal parasitic infection in the study population was 18.4% (n=30). Protozoa (Cryptosporidium spp., E. histolytica, G. lamblia and Pentatrichomonas hominis) and helminths (Taenia spp., A. lumbricoides, S. stercoralis, T. trichuria and H. nana) were detected in 12.9% (n=21) and 5.5% (n=9) of patients, respectively. The likelihood for having a parasitic infection was more than eight times higher in participants having diarrhoea. No oocysts of coccidian parasites were detected in the routinely performed wet mount stool microscopy, as expected.
Conclusions: There was a high prevalence of opportunistic intestinal parasitic infection in the studied population. Considering the clinical relevance of opportunistic infections particularly in individuals with low CD4 cell count and diarrhoea, the implementation of both stool concentration and modified acid fast staining techniques should be considered to enhance the quality of health care service for HIV-infected patients in resource-limited settings as Ethiopia.