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Published in: BMC Infectious Diseases 1/2019

Open Access 01-12-2019 | Anemia | Research article

Intestinal parasitosis in relation to CD4 count and anemia among ART initiated patients in St. Mary Aksum general hospital, Tigray, Ethiopia

Authors: Tuom Gebrewahid, Gebretsadkan Gebrekirstos, Mebrahtu Teweldemedhin, Hailay Gebreyesus, Abrham Awala, Kiros Tadla

Published in: BMC Infectious Diseases | Issue 1/2019

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Abstract

Background

The geographical distribution of intestinal parasites with conditions of poverty in most countries of sub-Saharan Africa coincides with that of HIV/AIDS. However, there is paucity of studies investigating the relationship between intestinal parasitic infections with CD4 counts and anemia in HIV/AIDS patients starting Antiretroviral Therapy (ART) in this region particularly and in Ethiopia in general. The aim of this study was to determine the prevalence of intestinal parasitic infections in relation to CD4 count and anemia among ART-initiated patients in St. Mary Aksum General Hospital, Tigray, Ethiopia.

Methods

A cross-sectional study was conducted among randomly selected 242 ART-initiated participants during February to April 2017 in St. Mary Aksum General hospital. Data was collected using structured questionnaire and laboratory examination. Logistic regression was applied to assess any association between explanatory factors and outcome variables (P values < 0.05).

Result

The overall prevalence of intestinal parasites was 26.4% and among the six types of parasitic genera identified Entamoeba histolytica/dispar (18.6%) and Giardia lamblia (2.1%) were the leading. According to the multivariate analysis, lack of hand washing before meal, eating uncooked vegetables, history of taking anti-parasite medication, stool consistency, and anemia were strongly associated with intestinal parasitosis.

Conclusion

There was a high prevalence of intestinal parasites among HIV positive individuals. Intervention measures such as deworming, improving hygiene and sanitation practices should be strengthened to reduce the burden of intestinal parasites among people living with HIV.
Appendix
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Literature
1.
go back to reference Teklemariam Z, Abate D, Mitiku H, Dessie Y. Prevalence of intestinal parasitic infection among HIV positive persons who are naive and on antiretroviral treatment in Hiwot Fana Specialized University hospital. Eastern Ethiopia ISRN AIDS. 2013;2013. Teklemariam Z, Abate D, Mitiku H, Dessie Y. Prevalence of intestinal parasitic infection among HIV positive persons who are naive and on antiretroviral treatment in Hiwot Fana Specialized University hospital. Eastern Ethiopia ISRN AIDS. 2013;2013.
2.
go back to reference Gelaw A, Anagaw B, Nigussie B, Silesh B, Yirga A, Alem M, et al. Prevalence of intestinal parasitic infections and risk factors among schoolchildren at the University of Gondar Community School, Northwest Ethiopia: a cross-sectional study. BMC Public Health. 2013;13(1):1.CrossRef Gelaw A, Anagaw B, Nigussie B, Silesh B, Yirga A, Alem M, et al. Prevalence of intestinal parasitic infections and risk factors among schoolchildren at the University of Gondar Community School, Northwest Ethiopia: a cross-sectional study. BMC Public Health. 2013;13(1):1.CrossRef
3.
go back to reference Kwitshana Z, Tsoka J, Mabaso M. Intestinal parasitic infections in adult patients in KwaZulu-Natal. SAMJ: South African Medical Journal. 2008;98(9):709–11.PubMed Kwitshana Z, Tsoka J, Mabaso M. Intestinal parasitic infections in adult patients in KwaZulu-Natal. SAMJ: South African Medical Journal. 2008;98(9):709–11.PubMed
4.
go back to reference Jam S, Ramezani A, Sabzvari D, Moradmand-Badie B, SeyedAlinaghi S, Jabbari H, et al. A cross-sectional study of anemia in human immunodeficiency virus-infected patients in Iran. Arch Iran Med. 2009;12(2):145–50.PubMed Jam S, Ramezani A, Sabzvari D, Moradmand-Badie B, SeyedAlinaghi S, Jabbari H, et al. A cross-sectional study of anemia in human immunodeficiency virus-infected patients in Iran. Arch Iran Med. 2009;12(2):145–50.PubMed
5.
go back to reference Babatunde S, Salami A, Fabiyi J, Agbede O, Desalu O. Prevalence of intestinal parasitic infestation in HIV seropositive and seronegative patients in Ilorin, Nigeria. Annals of African medicine. 2010;9(3). Babatunde S, Salami A, Fabiyi J, Agbede O, Desalu O. Prevalence of intestinal parasitic infestation in HIV seropositive and seronegative patients in Ilorin, Nigeria. Annals of African medicine. 2010;9(3).
6.
go back to reference Asma I, Johari S, Sim B, Lim Y. How common is intestinal parasitism in HIV-infected patients in Malaysia. Trop Biomed. 2011;28(2):400–10.PubMed Asma I, Johari S, Sim B, Lim Y. How common is intestinal parasitism in HIV-infected patients in Malaysia. Trop Biomed. 2011;28(2):400–10.PubMed
7.
go back to reference Gebreslassie M, Dejenie T. Tomass Z. Northern Ethiopia: Prevalence of Intestinal Parasites and Associated Risk Factors in Schoolchildren of Aksum Town; 2015. Gebreslassie M, Dejenie T. Tomass Z. Northern Ethiopia: Prevalence of Intestinal Parasites and Associated Risk Factors in Schoolchildren of Aksum Town; 2015.
8.
go back to reference Arani AS, Alaghehbandan R, Akhlaghi L, Shahi M, Lari AR. Prevalence of intestinal parasites in a population in south of Tehran, Iran. Rev Inst Med Trop Sao Paulo. 2008;50(3):145–9.CrossRef Arani AS, Alaghehbandan R, Akhlaghi L, Shahi M, Lari AR. Prevalence of intestinal parasites in a population in south of Tehran, Iran. Rev Inst Med Trop Sao Paulo. 2008;50(3):145–9.CrossRef
9.
go back to reference Brooker S, Kabatereine NB, Smith JL, Mupfasoni D, Mwanje MT, Ndayishimiye O, et al. An updated atlas of human helminth infections: the example of East Africa. Int J Health Geogr. 2009;8(1):1.CrossRef Brooker S, Kabatereine NB, Smith JL, Mupfasoni D, Mwanje MT, Ndayishimiye O, et al. An updated atlas of human helminth infections: the example of East Africa. Int J Health Geogr. 2009;8(1):1.CrossRef
10.
go back to reference Mugisha JO, Shafer LA, Paal D, Van L, Mayanja BN, Eotu H, et al. Anaemia in a rural Ugandan HIV cohort: prevalence at enrolment, incidence, diagnosis and associated factors. Tropical Med Int Health. 2008;13(6):788–94.CrossRef Mugisha JO, Shafer LA, Paal D, Van L, Mayanja BN, Eotu H, et al. Anaemia in a rural Ugandan HIV cohort: prevalence at enrolment, incidence, diagnosis and associated factors. Tropical Med Int Health. 2008;13(6):788–94.CrossRef
11.
go back to reference Dhurve SA, Dhurve AS. Bone Marrow Abnormalities in HIV Disease. Mediterranean Journal of Hematology & Infectious Diseases. 2013;5(1). Dhurve SA, Dhurve AS. Bone Marrow Abnormalities in HIV Disease. Mediterranean Journal of Hematology & Infectious Diseases. 2013;5(1).
12.
go back to reference Righetti AA, Adiossan LG, Ouattara M, Glinz D, Hurrell RF, N'Goran EK, et al. Dynamics of anemia in relation to parasitic infections, micronutrient status, and increasing age in south-central Côte d'Ivoire. J. Infect. Dis. 2013:jit066. Righetti AA, Adiossan LG, Ouattara M, Glinz D, Hurrell RF, N'Goran EK, et al. Dynamics of anemia in relation to parasitic infections, micronutrient status, and increasing age in south-central Côte d'Ivoire. J. Infect. Dis. 2013:jit066.
13.
go back to reference Tadesse K, Haile F, Hiruy N. Predictors of mortality among patients enrolled on antiretroviral therapy in Aksum hospital, northern Ethiopia: a retrospective cohort study. PLoS One. 2014;9(1):e87392.CrossRef Tadesse K, Haile F, Hiruy N. Predictors of mortality among patients enrolled on antiretroviral therapy in Aksum hospital, northern Ethiopia: a retrospective cohort study. PLoS One. 2014;9(1):e87392.CrossRef
14.
go back to reference Shah U, Purohit B, Chandralekha D, Mapara M. Coinfection with cryptosporidium, isospora and s. stercoralis in a patient with aids-A case report. Indian J. Med. Microbiol. 2003;21(2):137.PubMed Shah U, Purohit B, Chandralekha D, Mapara M. Coinfection with cryptosporidium, isospora and s. stercoralis in a patient with aids-A case report. Indian J. Med. Microbiol. 2003;21(2):137.PubMed
15.
go back to reference Mengistu A, Gebre-Selassie S, Kassa T. Prevalence of intestinal parasitic infections among urban dwellers in Southwest Ethiopia. Ethiop J Health Dev. 2007;21(1):12–7. Mengistu A, Gebre-Selassie S, Kassa T. Prevalence of intestinal parasitic infections among urban dwellers in Southwest Ethiopia. Ethiop J Health Dev. 2007;21(1):12–7.
16.
go back to reference Adamu H, Petros B, Zhang G, Kassa H, Amer S, Ye J, et al. Distribution and clinical manifestations of Cryptosporidium species and subtypes in HIV/AIDS patients in Ethiopia. PLoS Negl Trop Dis. 2014;8(4):e2831.CrossRef Adamu H, Petros B, Zhang G, Kassa H, Amer S, Ye J, et al. Distribution and clinical manifestations of Cryptosporidium species and subtypes in HIV/AIDS patients in Ethiopia. PLoS Negl Trop Dis. 2014;8(4):e2831.CrossRef
17.
go back to reference Xiao L. Molecular epidemiology of cryptosporidiosis: an update. Exp Parasitol. 2010;124(1):80–9.CrossRef Xiao L. Molecular epidemiology of cryptosporidiosis: an update. Exp Parasitol. 2010;124(1):80–9.CrossRef
18.
go back to reference Gerzmu T, Fantahun E, Hailu E, Kibe H, Fesseha O, Godana W. Prevalence of intestinal parasitosis among HIV/AIDS patients attending ART clinic of Arbaminch hospital. African Journal of Science and Research. 2015;4(5):13–7. Gerzmu T, Fantahun E, Hailu E, Kibe H, Fesseha O, Godana W. Prevalence of intestinal parasitosis among HIV/AIDS patients attending ART clinic of Arbaminch hospital. African Journal of Science and Research. 2015;4(5):13–7.
19.
go back to reference Akinbo FO, Omoregie R, Eromwon R, Igbenimah IO, Airueghiomon U-E. Prevalence of intestinal parasites among patients of a tertiary hospital in Benin city, Nigeria. N Am J Med Sci. 2011;3(10):462.CrossRef Akinbo FO, Omoregie R, Eromwon R, Igbenimah IO, Airueghiomon U-E. Prevalence of intestinal parasites among patients of a tertiary hospital in Benin city, Nigeria. N Am J Med Sci. 2011;3(10):462.CrossRef
20.
go back to reference Missaye A, Dagnew M, Alemu A, Alemu A. 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 Res Ther. 2013;10(1):1.CrossRef Missaye A, Dagnew M, Alemu A, Alemu A. 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 Res Ther. 2013;10(1):1.CrossRef
21.
go back to reference Cheesbrough M. District laboratory practice in tropical countries: Part 2. District laboratory practice in tropical countries: Part 2. 2006(Ed. 2). Cheesbrough M. District laboratory practice in tropical countries: Part 2. District laboratory practice in tropical countries: Part 2. 2006(Ed. 2).
22.
go back to reference Mohammed H. Modified Ziehl-Neelson method. EHNRI. 2010;11:1–8. Mohammed H. Modified Ziehl-Neelson method. EHNRI. 2010;11:1–8.
23.
go back to reference Taye B, Desta K, Ejigu S, Dori GU. The magnitude and risk factors of intestinal parasitic infection in relation to human immunodeficiency virus infection and immune status, at ALERT hospital, Addis Ababa. Ethiopia Parasitology international. 2014;63(3):550–6.CrossRef Taye B, Desta K, Ejigu S, Dori GU. The magnitude and risk factors of intestinal parasitic infection in relation to human immunodeficiency virus infection and immune status, at ALERT hospital, Addis Ababa. Ethiopia Parasitology international. 2014;63(3):550–6.CrossRef
24.
go back to reference Kiros H, Nibret E, Munshea A, Kerisew B, Adal M. Prevalence of intestinal protozoan infections among individuals living with HIV/AIDS at Felegehiwot referral hospital, Bahir Dar. Ethiopia International Journal of Infectious Diseases. 2015;35:80–6.CrossRef Kiros H, Nibret E, Munshea A, Kerisew B, Adal M. Prevalence of intestinal protozoan infections among individuals living with HIV/AIDS at Felegehiwot referral hospital, Bahir Dar. Ethiopia International Journal of Infectious Diseases. 2015;35:80–6.CrossRef
25.
go back to reference Jegede EF, Oyeyi ETI, Bichi AH, Mbah HA, Torpey K. Prevalence of intestinal parasites among HIV/AIDS patients attending Infectious Disease Hospital Kano, Nigeria. Pan African Medical Journal. 2014;17(295). Jegede EF, Oyeyi ETI, Bichi AH, Mbah HA, Torpey K. Prevalence of intestinal parasites among HIV/AIDS patients attending Infectious Disease Hospital Kano, Nigeria. Pan African Medical Journal. 2014;17(295).
26.
go back to reference Gedle D, Kumera G, Eshete T, Ketema K, Adugna H, Feyera F. Intestinal parasitic infections and its association with undernutrition and CD4 T cell levels among HIV/AIDS patients on HAART in Butajira, Ethiopia. Journal of Health, Population and Nutrition. 2017;36(1):15. Gedle D, Kumera G, Eshete T, Ketema K, Adugna H, Feyera F. Intestinal parasitic infections and its association with undernutrition and CD4 T cell levels among HIV/AIDS patients on HAART in Butajira, Ethiopia. Journal of Health, Population and Nutrition. 2017;36(1):15.
27.
go back to reference Akinbo FO, Omoregie R. Intestinal parasitic infections in human-immunodeficiency-virus-infected persons on highly active antiretroviral therapy in Benin City, Nigeria. Genomic Medicine, Biomarkers, and Health Sciences. 2011;3(3):119–22.CrossRef Akinbo FO, Omoregie R. Intestinal parasitic infections in human-immunodeficiency-virus-infected persons on highly active antiretroviral therapy in Benin City, Nigeria. Genomic Medicine, Biomarkers, and Health Sciences. 2011;3(3):119–22.CrossRef
28.
go back to reference Dufera M, Petros B, Endeshaw T, Mohammed H, Kassu A. Opportunistic intestinal protozoan parasites among HIV positive patients on antiretroviral therapy at Nekemte hospital, West Ethiopia. Ethiopian Journal of Health and Biomedical Science. 2014;1(1). Dufera M, Petros B, Endeshaw T, Mohammed H, Kassu A. Opportunistic intestinal protozoan parasites among HIV positive patients on antiretroviral therapy at Nekemte hospital, West Ethiopia. Ethiopian Journal of Health and Biomedical Science. 2014;1(1).
29.
go back to reference Mariam ZT, Abebe G, Mulu A. Opportunistic and other intestinal parasitic infections in AIDS patients, HIV seropositive healthy carriers and HIV seronegative individuals in Southwest Ethiopia. East African journal of public health. 2008;5(3):169–73.PubMed Mariam ZT, Abebe G, Mulu A. Opportunistic and other intestinal parasitic infections in AIDS patients, HIV seropositive healthy carriers and HIV seronegative individuals in Southwest Ethiopia. East African journal of public health. 2008;5(3):169–73.PubMed
30.
go back to reference Nkenfou CN, Nana CT, Payne VK. Intestinal parasitic infections in HIV infected and non-infected patients in a low HIV prevalence region. West-Cameroon PloS one. 2013;8(2):e57914.CrossRef Nkenfou CN, Nana CT, Payne VK. Intestinal parasitic infections in HIV infected and non-infected patients in a low HIV prevalence region. West-Cameroon PloS one. 2013;8(2):e57914.CrossRef
31.
go back to reference Zeynudin A, Hemalatha K, Kannan S. Prevalence of opportunistic intestinal parasitic infection among HIV infected patients who are taking antiretroviral treatment at Jimma health center, Jimma, Ethiopia. Eur Rev Med Pharmacol Sci. 2013;17:513–6.PubMed Zeynudin A, Hemalatha K, Kannan S. Prevalence of opportunistic intestinal parasitic infection among HIV infected patients who are taking antiretroviral treatment at Jimma health center, Jimma, Ethiopia. Eur Rev Med Pharmacol Sci. 2013;17:513–6.PubMed
32.
go back to reference Nsagha DS, Njunda AL, Assob NJC, Ayima CW, Tanue EA, Kwenti TE. Intestinal parasitic infections in relation to CD4+ T cell counts and diarrhea in HIV/AIDS patients with or without antiretroviral therapy in Cameroon. BMC Infect Dis. 2016;16(1):9.CrossRef Nsagha DS, Njunda AL, Assob NJC, Ayima CW, Tanue EA, Kwenti TE. Intestinal parasitic infections in relation to CD4+ T cell counts and diarrhea in HIV/AIDS patients with or without antiretroviral therapy in Cameroon. BMC Infect Dis. 2016;16(1):9.CrossRef
33.
go back to reference Assefa S, Erko B, Medhin G, Assefa Z, Shimelis T. Intestinal parasitic infections in relation to HIV/AIDS status, diarrhea and CD4 T-cell count. BMC Infect Dis. 2009;9(1):1.CrossRef Assefa S, Erko B, Medhin G, Assefa Z, Shimelis T. Intestinal parasitic infections in relation to HIV/AIDS status, diarrhea and CD4 T-cell count. BMC Infect Dis. 2009;9(1):1.CrossRef
34.
go back to reference Adamu H, Wegayehu T, Petros B. High prevalence of diarrhoegenic intestinal parasite infections among non-ART HIV patients in Fitche hospital. Ethiopia PloS one. 2013;8(8):e72634.CrossRef Adamu H, Wegayehu T, Petros B. High prevalence of diarrhoegenic intestinal parasite infections among non-ART HIV patients in Fitche hospital. Ethiopia PloS one. 2013;8(8):e72634.CrossRef
35.
go back to reference Mahmud MA, Bezabih AM, Gebru RB. Risk factors for intestinal parasitosis among antiretroviral treated HIV/AIDS patients in Ethiopia. Int J STD AIDS. 2014;0956462414520803. Mahmud MA, Bezabih AM, Gebru RB. Risk factors for intestinal parasitosis among antiretroviral treated HIV/AIDS patients in Ethiopia. Int J STD AIDS. 2014;0956462414520803.
36.
go back to reference Adamu H, Petros B. Intestinal protozoan infections among HIV positive persons with and without Antiretroviral Treatment (ART) in selected ART centers in Adama, Afar and Dire-Dawa, Ethiopia. Ethiopian Journal of Health Development. 2009;23(2). Adamu H, Petros B. Intestinal protozoan infections among HIV positive persons with and without Antiretroviral Treatment (ART) in selected ART centers in Adama, Afar and Dire-Dawa, Ethiopia. Ethiopian Journal of Health Development. 2009;23(2).
37.
go back to reference Alemu A, Shiferaw Y, Getnet G, Yalew A, Addis Z. Opportunistic and other intestinal parasites among HIV/AIDS patients attending Gambi higher clinic in Bahir Dar city, north West Ethiopia. Asian Pac J Trop Med. 2011;4(8):661–5.CrossRef Alemu A, Shiferaw Y, Getnet G, Yalew A, Addis Z. Opportunistic and other intestinal parasites among HIV/AIDS patients attending Gambi higher clinic in Bahir Dar city, north West Ethiopia. Asian Pac J Trop Med. 2011;4(8):661–5.CrossRef
38.
go back to reference Hylemariam M. Intestinal Parasitosis in relation to CD4+ T cells levels and Anemia among HAART initiated and non-HAART initiated pediatric HIV patients in Zewditu memorial hospital. Addis Ababa, Ethiopia: AAU; 2014. Hylemariam M. Intestinal Parasitosis in relation to CD4+ T cells levels and Anemia among HAART initiated and non-HAART initiated pediatric HIV patients in Zewditu memorial hospital. Addis Ababa, Ethiopia: AAU; 2014.
39.
go back to reference Nsagha DS, Njunda AL, Assob NJC, Ayima CW, Tanue EA, Kwenti TE. Intestinal parasitic infections in relation to CD4+ T cell counts and diarrhea in HIV/AIDS patients with or without antiretroviral therapy in Cameroon. BMC Infect Dis. 2016;16(1):1. Nsagha DS, Njunda AL, Assob NJC, Ayima CW, Tanue EA, Kwenti TE. Intestinal parasitic infections in relation to CD4+ T cell counts and diarrhea in HIV/AIDS patients with or without antiretroviral therapy in Cameroon. BMC Infect Dis. 2016;16(1):1.
40.
go back to reference Bachur TPR, Vale JM, Coêlho ICB, TRBSd Q, CdS C. Enteric parasitic infections in HIV/AIDS patients before and after the highly active antiretroviral therapy. Braz J Infect Dis. 2008;12(2):115–22.CrossRef Bachur TPR, Vale JM, Coêlho ICB, TRBSd Q, CdS C. Enteric parasitic infections in HIV/AIDS patients before and after the highly active antiretroviral therapy. Braz J Infect Dis. 2008;12(2):115–22.CrossRef
41.
go back to reference Shimelis T, Tassachew Y, Lambiyo T. Cryptosporidium and other intestinal parasitic infections among HIV patients in southern Ethiopia: significance of improved HIV-related care. Parasit Vectors. 2016;9(1):1.CrossRef Shimelis T, Tassachew Y, Lambiyo T. Cryptosporidium and other intestinal parasitic infections among HIV patients in southern Ethiopia: significance of improved HIV-related care. Parasit Vectors. 2016;9(1):1.CrossRef
42.
go back to reference Girma M, Teshome W, Petros B, Endeshaw T. Cryptosporidiosis and Isosporiasis among HIV-positive individuals in South Ethiopia: a cross sectional study. BMC Infect Dis. 2014;14(1):100.CrossRef Girma M, Teshome W, Petros B, Endeshaw T. Cryptosporidiosis and Isosporiasis among HIV-positive individuals in South Ethiopia: a cross sectional study. BMC Infect Dis. 2014;14(1):100.CrossRef
43.
go back to reference Akinbo FO, Okaka CE, Omoregie R. Prevalence of intestinal parasites in relation to CD4 counts and anaemia among HIV-infected patients in Benin City, Edo state, Nigeria. Tanzania journal of health research. 2011;13(1):8–13.CrossRef Akinbo FO, Okaka CE, Omoregie R. Prevalence of intestinal parasites in relation to CD4 counts and anaemia among HIV-infected patients in Benin City, Edo state, Nigeria. Tanzania journal of health research. 2011;13(1):8–13.CrossRef
Metadata
Title
Intestinal parasitosis in relation to CD4 count and anemia among ART initiated patients in St. Mary Aksum general hospital, Tigray, Ethiopia
Authors
Tuom Gebrewahid
Gebretsadkan Gebrekirstos
Mebrahtu Teweldemedhin
Hailay Gebreyesus
Abrham Awala
Kiros Tadla
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2019
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-019-3989-0

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