CRYPTOSPORIDIOSIS AMONG HIV PATIENTS PRESENTING WITH DIARRHOEA BETWEEN SEPTEMBER TO DECEMBER, 2012

(A CASE STUDY OF SPECIALIST HOSPITAL SOKOTO, NIGERIA)

By

Author

Presented To

Department of Medicine

ABSTRACT
Diarrhoea remains one of the most important health problems globally and a leading cause of morbidity and mortality among immuno compromised individuals. It accounts for over 50 million deaths (in all ages) world-wide and it ranks 3rd among diseases responsible for human mortality globally1. This study was carried out to determine the prevalence of Cryptosporidium parvum infection among HIV patients visiting the Specialist Hospital Sokoto (SHS), Nigeria. A total of 150 stool samples were examined for oocysts of C. parvum using the Stool concentration technique and modified Zeil-Neilson staining technique. 85 females and 65 males were tested. The overall parasite prevalence of Human intestinal parasites encountered in the study was 22.7% (34/150) with Cryptosporidium parvum 4.0%, being the highest compared to other parasites. The age group distribution of Cryptosporidium prevalence among HIV infected patients who had diarrhoea was 4.0%. With the highest prevalence among patients aged 46-55years when compared to 0.0 % prevalence recorded in those aged 6 -15, 16 – 25 and 56 -60. Crypto was commoner among female patients (2.6) when compared to the male (1.4) prevalence. There is no significant statistical difference between the two groups at 95 % Confidence. Limit. The observed monthly prevalence of Crypto among the vulnerable group was observed to be high in the month of November. There is significant statistical difference between all the four at 95% confidence limit. On the other hand, the prevalence of Crypto among different drugs regiment (combination) was found to be higher among Regimen 1A. The observed prevalence among CD4 groups showed higher prevalence 2.7 % among HIV patients with diarrhoea whose CD4 were xv below 350 who at the same time formed majority of the patients tested (139 patients) compare to the least prevalence 1.3 % recorded among patients with CD4 greater than 350. There is observed significant statistical difference between the two categories. 4.0 % of crypto encountered among HIV patients with diarrhea and blood only, OR 1.03, 95% CI 0.20 85.27, P - value 0.7 when compared to 0.0 % Crypto prevalence recorded among diarrhea with blood and mucus and diarrhea with mucus only. From the result of this study, Crypto was therefore found to be associated with HIV diarrhea particularly in the advanced stage of the infection as Cryptosporidium Oocysts have been demonstrated in faeces of HIV infected patients attending Specialist Hospital. It accounts for 4.0% of diarrhoeal cases among this group. This study provides baseline data on the prevalence of Cryptosporidiosis among HIV infected patients presenting with diarrhea and the relationship between CD4 and ART regimen. It is therefore recommended that information and findings obtained from this study be considered in planning interventions aimed at managing diarrhea diseases among HIV and other immune-suppressed patients.