Intestinal parasitic infections among HIV/AIDS patients in relation to ART adherence in Nigeria

https://dx.doi.org/10.4314/njpar.v44i1.13

Authors

  • E. O. Udeh Centre for Integrated Health Programs, Abuja, Nigeria
  • R. N. N. Obiezue Parasitology and Public Health Research Unit, Department of Zoology and Environmental Biology, University of Nigeria Nsukka, Enugu State, Nigeria 
  • C. B. Ikele Parasitology and Public Health Research Unit, Department of Zoology and Environmental Biology, University of Nigeria Nsukka, Enugu State, Nigeria 
  • C. A. Otuu Parasitology and Public Health Research Unit, Department of Zoology and Environmental Biology, University of Nigeria Nsukka, Enugu State, Nigeria 
  • I. C. Okoye Parasitology and Public Health Research Unit, Department of Zoology and Environmental Biology, University of Nigeria Nsukka, Enugu State, Nigeria 
  • S. S. Eke Department of Biological Sciences, Airforce Institute of Technology, Kaduna, Kaduna State, Nigeria
  • F. C. Okafor Parasitology and Public Health Research Unit, Department of Zoology and Environmental Biology, University of Nigeria Nsukka, Enugu State, Nigeria 
  • O. N. Goselle Applied Entomology and Parasitology Research Unit, Department of Zoology, University of Jos, Jos, Plateau State, Nigeria
  • P. Jwanle APIN Public Health Nigeria, Abuja, Nigeria
  • N. S. Iheanacho Department of Medical Microbiology and Parasitology, Benue State University Teaching Hospital, Makurdi, Benue State, Nigeria
  • P. O. Abba Department of Medical Microbiology and Parasitology, Benue State University Teaching Hospital, Makurdi, Benue State, Nigeria
  • N. M. Amali Department of Medical Microbiology and Parasitology, Benue State University Teaching Hospital, Makurdi, Benue State, Nigeria

Keywords:

Intestinal parasitic infections, HIV, ART, Adherence

Abstract

Intestinal parasitic infections (IPI) cause morbidity among HIV-infected individuals. Poor adherence to antiretroviral therapy (ART) affects treatment outcomes, especially in low-middle-income countries. The study evaluated the prevalence of IPI among HIV patients in relation to ART adherence between May and November 2017. Ethical approval and consent were obtained from the ethical review committee of the Benue State Ministry of Health and patients respectively. Patients’ clinical records were reviewed, and ART adherence status was obtained from the adherence assessment cards. Participants were given two labelled sterile containers for stool samples. Direct wet mount of samples was prepared in normal saline to identify helminths ova and larvae. Samples were further processed using parasite concentrators. Slides were stained with Lugol’s iodine, modified Ziehl-Neelsen acid-fast and Giemsa and subsequently examined under a light microscope using x10 and x40 objectives. Data were analysed using the chi-square test and SPSS version 22. Of the 757 patients, females constituted 57.7% (n=437). Good adherence rate (>95%) was 61.9% (n=469). More females (n=301, 64.2%) than males (n=168, 35.8%) had good adherence status. IPI rate among ART patients was 16.4% (n=124). Entamoeba histolytica (n=5, 1.0%), Giardia lamblia (n=3, 0.6%) and Taenia sp. (n=8, 1.7%) were IPI seen among good adherence patients, and as single infections without diarrhoea. IPI was significant (p<0.05) among poor adherence patients (37.5%, n=108) compared to good adherence patients (3.4%, n=16). IPI were significant among females; 1.9% (n=9) in the good adherence group and 19.8% (n=57) in the poor adherence group. Cryptosporidium parvum (n=20, 6.9%), E. histolytica (n=15, 5.2%), E. coli (n=11, 3.8%), G. lamblia (n=10, 3.5%) and Taenia sp. (n=10, 3.5%) accounts for significant rates of infections among patients with poor adherence, with multiple infections and associated diarrhoea seen in 10 (3.5%) of them. Routine monitoring of HIV/AIDS patients for IPI by healthcare providers is necessary. Coinfected patients with poor ART adherence should be routinely screened for IPI and promptly treated. Antiparasitic drugs should be provided as prophylaxis along with ART, to enhance their overall treatment outcome.

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References

Ngui, R., Ishak, S., Chuen, C. S., Mahmud, R., and Lim, Y. A. L. (2011). Prevalence and risk factors of intestinal parasitism in rural and remote West Malaysia. PLoS Neglected Tropical Diseases 5(3), e974. DOI:10.1371/journal.pntd.0000974.

Adamu, H and Petros, B. (2009). Intestinal protozoan infections among HIV positive persons with and without antiretroviral

treatment (ART) in selected ART centers in Adama, Afar and Dire-Dawa, Ethiopia. Ethiopia Journal of Health Development 23:

– 140.

Hotez, P. J., Fenwick, A., Savioli, L. and Molyneux, D. H. (2009). Rescuing the bottom billion through control of neglected tropical diseases. Lancet 373: 1570 – 1575.

UNAIDS (2017). World AIDS day fact sheet.

Webb, E. L., Ekii, A. O. and Pala, P. (2012). Epidemiology and immunology of helminths and HIV interactions. Current Opinion HIVAIDS 7: 245 – 253.

Udeh, E. O., Duhlinska-Popova, D. D., Goselle, O. N. and Abelau, A. M. (2008). Prevalence of intestinal protozoans in HIV/AIDS subjects in Abuja, Nigeria. Science World Journal 3(3): 1 – 4.

Shah, U. V., Purohit, B. C., Chandralekha, D. and Mapara, M. H. (2005). Co-infection with Cryptosporidium, Isospora and S. stercoralis in a patient with AIDS- a case report. Indian Journal of Medical Microbiology 21: 137 – 138.

Kelly, P. (1998). Diarrhea and AIDS: recent developments in the African settings. African Health, 1: 16 – 18.

Goodgame, R. W. (1996). Understanding intestinal spore forming protozoa: Cryptosporidia, Microsporidia, Isospora and Cyclospora. Annals of Internal Medicine 124: 429 – 441.

Missaye, A., Dagnew, M. and Alemu, A. (2013). Prevalence of intestinal parasites and associated risk factors among HIV/AIDS

patients with pre-ART and on-ART attending Dessie Hospital ART clinic, Northeast Ethiopia. AIDS Research and Therapy 10: 7. doi: 10.1186/1742-6405-10- 7.

Lawn, S. D., Myer, L., Orrell, C., Bekker, L. G. and Wood, R. (2005). Early mortality among adults accessing a community-based

antiretroviral service in South Africa: implications for programme design. AIDS 19: 2141 – 2148.

World Health Organization (2016). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. RecommendationsSwitzerland for a public health approach. Geneva, Switzerland: World Health Organization.

Achappa, B., Madi, D., Bhaskaran, U., Ramapuram, J. T., Rao, S. and Mahalingam, S. (2013). Adherence to antiretroviral therapy among people living with HIV. North American Journal of Medical Sciences 5(3): 220 – 223.

Federal Ministry of Health Nigeria (2016). National Guidelines for HIV Prevention Treatment and Care. National AIDS and STIs Control Program, Federal Ministry of Health Nigeria.

Devi, S. B. and Robinson-Ningshen, A. G. (2012). Burden of opportunistic infections in HIV/AIDS subjects in the highly active

antiretroviral therapy era: A regional institute of Medical Sciences, Imphal Perspective. Human Immunodeficiency Virus, 63 – 66.

Sher, A., Gazzinelli, R. T., Osward, I. P., Clemici, M., Kullbera, M., Pearce, E. J., Berzofsky, A. J., Mosmann, T. R., James, S. L., Morse, III H. C., and Sheaner, G. M. (1992): The Role of T-cell drives cytokines in the regulation of immune responses in parasitic and retroviral infection.

Immunological Review 127: 183 – 204.

Weber, R., Bryan, R. R. T., Owen, R. L., Wilcox, C. M., Gorelkin, L. and Visvesvara, G. S. (1992): Improved high microscopical detection of microsporidia spores in stool and duodenal aspirates. New England Journal of Medicine 32: 161 – 166.

Hung, C. C. and Chang, S. C. (2004). Impact of highly active antiretroviral therapy on incidence and management of human immunodeficiencyvirus-related opportunistic infections. Journal of Antimicrobial Chemotherapy 54: 849 – 853.

Tay, S. C. K., Aryee, E. N. O. and Badu, K. (2017). Intestinal parasitemia and HIV/AIDS co-infections at varying CD+4 tcell levels. HIV/AIDS Research and Treatment Open Journal 4(1): 40 – 48.

Galisteu, K. J., Cardoso, L. V., Furini, A. A. C., Schiesari-Júnior, A., Cesarino, C. B., Franco, C., Baptista., A. R. S. and Machado, R. L. D. (2015). Opportunistic infections among individuals with HIV- 1/AIDS in the highly active antiretroviral therapy era at a quaternary level care

teaching hospital. Revista da Sociedade Brasileira de Medicina Tropical 48(2): 149 – 156.

Mitiku, H., Weldegebreal, F. and Teklemariam, Z. (2015). Magnitude of opportunistic infections and associated factors in HIV-infected adults on antiretroviral therapy in Eastern Ethiopia. HIV/AIDS Research and Palliative Care 7: 137 – 144.

Alemu, F. (2014). Prevalence of intestinal parasites and other parasites among HIV/AIDS patients on-ART attending Dilla Referral Hospital, Ethiopia. Journal of AIDS Clinical and Research, 5(9): 1 – 5.

Adamu, H., Wegayehu, T. and Petros, B. (2013). High prevalence of diarrhoeagenic intestinal parasite infections among nonART HIV patients in Fitche Hospital, Ethiopia. PLoS ONE 8(8): e72634.

Sow, P. G., Coume, M., Ndiaye, P. P., Boucal, J. C. and Amousouguenou, G. (2012). About intestinal parasitic infections in a cohort of HIV-infected patients. Advances in Bioresearch 3 (2): 32 – 35.

Akinbo, F. O., Okaka, C. E. and Omoregie, R. (2010). Prevalence of intestinal parasitic infections among HIV patients in Benin City, Nigeria. Libyan Journal of Medicine 5:1 – 6.

Maduka, O. and Tobin-West, C. I. (2014). Barriers to HIV treatment adherence; findings from a treatment center in SouthSouth, Nigeria. International Journal of Tropical Diseases and Health 4(12): 1233 – 1244.

Adefolalu, A. O. and Nkosi, Z. Z. (2013). The complex nature of adherence in the management of HIV/AIDS as a chronic medical condition. Diseases 1: 18 – 35.

Ugwu, R. (2013). Factors influencing adherence to paediatric antiretroviral therapy in Port Harcourt, South- South Nigeria; The Pan African Medical Journal, 16: 30.

Bello, S. I. (2011). HIV/AIDS patients’ adherence to antiretroviral therapy in Sobi Specialist Hospital, Ilorin. Nigerian Journal of Advance Science Research 2(3): 52 – 57.

Olisah, V. O., Baiyewu, O. and Sheikh, T. L. (2010). Adherence to highly active antiretroviral therapy in depressed patients with HIV/AIDS attending a Nigerian University Teaching Hospital Clinic. African Journal of Psychiatry 13: 275 – 279.

Monjok, E., Smesny, A., Okokon, I. B., Mgbere, O. and Essien, E. J. (2010). Adherence to antiretroviral therapy in Nigeria: an overview of research studies and implications for policy and practice; HIV/AIDS Research and Palliative care 2: 69 – 76.

Uzochukwu, B. S. C., Onwujekwe, O. E., Onoka, A. C., Okoli, C., Uguru, N. P. and Chukwuogo, O. I. (2009). Determinants of

non-adherence to subsidized antiretroviral treatment in Southeast Nigeria. Health Policy Plan 24: 189 – 196.

Published

2023-03-01

How to Cite

Udeh, E. O., Obiezue, R. N. N., Ikele, C. B., Otuu, C. A., Okoye, I. C., Eke, S. S., … Amali, N. M. (2023). Intestinal parasitic infections among HIV/AIDS patients in relation to ART adherence in Nigeria: https://dx.doi.org/10.4314/njpar.v44i1.13. Nigerian Journal of Parasitology, 44(1), 128–136. Retrieved from https://njpar.com.ng/index.php/home/article/view/113

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