Intestinal parasitic infections in HIV-infected adult patients with, chronic diarrhoea at Kenyatta National Hospital
Infestations caused by intestinal parasites are common and occur in upto 50%of patients with HIV infection and chronic diarrhea. They are a major health problem and contribute greatly to the morbidity and mortality of these patients. Data on the pattern of intestinal parasite infestations is lacking locally. Such information can optimize the care of patients with HIV infection and chronic diarrhea. It was conducted at KNH (tertiary referral hospital in Kenya) between August and December 2005. This was a cross-sectional survey. Three hundred and ninety nine adult patients with HIV infection and chronic diarrhea were consecutively recruited after signing an informed consent. A blood sample and a stool specimen were taken from each patient for determination the CD4 counts and intestinal parasite infestations respectively. The prevalence of intestinal parasite infestation was found to be 36.8%. C. Parvum was the commonest opportunistic parasite isolated with a prevalence of II%. Other parasites detected included E. coli (7.5%), hookworm (4.3%), S. mansoni (2.0%) and T trichura (0.8%). A mean CD4 count of 194.58 cells/cc was found with a median of 152 cells/cc. The mean CD4 count in the patients who had at least one parasite was 152 as compared to 219 for those who did not have any parasite in their stool. This difference was statistically significant (P= 0.001). Intestinal parasitic infestations are common in HIV infected patients with chronic diarrhea. Low CD4 cell counts are associated with occurrence of intestinal opportunistic infections.