Olusola Adetunji Oyedeji1, Ebun Adejuyigbe2, Samuel Olorunyomi Oninla1, Abiodum Akeem Akindele3, Samuel Adeyinka Adedokun4, Efeturi Agelebe5. 1. Consultant Paediatrician, Department of Paediatrics, LAUTECH Teaching Hospital , Osogbo, Osun State, Nigeria . 2. Professor and Consultant Paediatrician, Department of paediatrics, Obafemi Awolowo University Teaching Hospitals , Compkex, Ile - Ife Osun State, Nigeria . 3. Biomedical Scientist, Department of Community Medicine, College of Health Sciences , Osogbo , Osun State, Nigeria . 4. Biomedical Scientist, Department of Community Medicine, College of Health Sciences Osogbo, Osun State, Nigeria . 5. Senior Registrar, Department of Paediatrics, LAUTECH Teaching Hospital , Osogbo, Osun State, Nigeria .
Abstract
BACKGROUND: Intestinal parasitoses are common amongst people living in developing countries. They may impact negatively on the growth and health of immune competent children. There is paucity of information on the association between HIV and intestinal parasitoses in African children. OBJECTIVE: To identify the intestinal infections responsible for infections in HIV infected children and document characteristics of HIV infected children at a Nigerian teaching hospital. MATERIALS AND METHODS: Consecutive children attending a Paediatric anti-retroviral clinic were studied. Information such as socio-demographics and clinical characteristics elicited from clinical examination were recorded in the proforma. Stool samples of the children were obtained and examined for intestinal parasites. Data was analysed with the SPSS 18 software. RESULTS: A total 52 children were studied and their age ranged between 6 months and 14 years, with a mean of 6.5 years ± 3.93. The 52 were made up of 27 boys and 25 girls, giving a male: female ratio of 1.1:1. 10 (19.2%) of the 52 children were infected with cryptosporidium spp, while 1(1.9%) had Ascaris lumbricoides infestation. Anti-helminthics had previously been administered to 86.5% of children studied. Those who previously received anti-helminthics had lower prevalence estimates of cryptosporidium infections. (p<0.01, RR = 0.42, 95%CI = 0.20 - 0.90). Children on co-trimoxazole prophylaxis had lower prevalence estimates of cryptosporidium infections. (P<0.01, RR = 0.35, 95%CI = 0.14 - 0.91). Use of highly active antiretroviral drugs was also associated with lower prevalence estimates of intestinal cryptosporidium. (p=0.04, RR = 0.58, 95%CI = 0.31 - 1.10). Eight of the 10 children infected with cryptosporidium had recurrent abdominal pain in comparison with the six with recurrent abdominal pain amongst the 42 without cryptosporidial infections. (p<0.01, RR=5.6, 95%CI= 2.51 - 12.1). CONCLUSION: Cryptosporidial infection is the most common intestinal parasitoses among HIV infected children in this study, while intestinal helminthiasis are not so common. Anti-helminthics, Co-trimoxazole prophylaxis and highly active anti-retroviral therapy have a protective effect against intestinal cryptosporidium. Screening for intestinal cryptosporidium is suggested in HIV infected children with recurrent abdominal pain, because of the statistically association.
BACKGROUND: Intestinal parasitoses are common amongst people living in developing countries. They may impact negatively on the growth and health of immune competent children. There is paucity of information on the association between HIV and intestinal parasitoses in African children. OBJECTIVE: To identify the intestinal infections responsible for infections in HIV infectedchildren and document characteristics of HIV infectedchildren at a Nigerian teaching hospital. MATERIALS AND METHODS: Consecutive children attending a Paediatric anti-retroviral clinic were studied. Information such as socio-demographics and clinical characteristics elicited from clinical examination were recorded in the proforma. Stool samples of the children were obtained and examined for intestinal parasites. Data was analysed with the SPSS 18 software. RESULTS: A total 52 children were studied and their age ranged between 6 months and 14 years, with a mean of 6.5 years ± 3.93. The 52 were made up of 27 boys and 25 girls, giving a male: female ratio of 1.1:1. 10 (19.2%) of the 52 children were infected with cryptosporidium spp, while 1(1.9%) had Ascaris lumbricoides infestation. Anti-helminthics had previously been administered to 86.5% of children studied. Those who previously received anti-helminthics had lower prevalence estimates of cryptosporidium infections. (p<0.01, RR = 0.42, 95%CI = 0.20 - 0.90). Children on co-trimoxazole prophylaxis had lower prevalence estimates of cryptosporidium infections. (P<0.01, RR = 0.35, 95%CI = 0.14 - 0.91). Use of highly active antiretroviral drugs was also associated with lower prevalence estimates of intestinal cryptosporidium. (p=0.04, RR = 0.58, 95%CI = 0.31 - 1.10). Eight of the 10 children infected with cryptosporidium had recurrent abdominal pain in comparison with the six with recurrent abdominal pain amongst the 42 without cryptosporidial infections. (p<0.01, RR=5.6, 95%CI= 2.51 - 12.1). CONCLUSION: Cryptosporidial infection is the most common intestinal parasitoses among HIV infectedchildren in this study, while intestinal helminthiasis are not so common. Anti-helminthics, Co-trimoxazole prophylaxis and highly active anti-retroviral therapy have a protective effect against intestinal cryptosporidium. Screening for intestinal cryptosporidium is suggested in HIV infectedchildren with recurrent abdominal pain, because of the statistically association.
Entities:
Keywords:
Gut; Helminths; Immunodeficiency; Infections and paediatrics
Authors: S V Kulkarni; R Kairon; S S Sane; P S Padmawar; V A Kale; M R Thakar; S M Mehendale; A R Risbud Journal: Indian J Med Res Date: 2009-07 Impact factor: 2.375
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