Gastrointestinal Tract Opportunistic Parasitic Infections among Hiv/Aids Patients under Ani-Reroviral Therapy in the Dschang Health District

Background: The analyses of the recurrence of opportunistic gastrointestinal parasitic infections is crucial for the effective management of HIV infection in sub-Saharan African countries where intestinal parasites are very common. More and recent information on the interested field is needed in order to better understand the magnitude of the problem. The present analytical case control study was designed in other to determine the prevalence of gastrointestinal opportunistic parasites and detect the associated risk factors among HIV positive patients in 4 sanitary centres in Dschang Health District (west Cameroon).

Methodology: Stool specimens were collected from 305 individuals, 97/305(31.8%) HIV positive patients and 208/305(68.2%) HIV negative participants. These specimens were examined for the research of gastrointestinal opportunistic parasites using the sedimentation concentration techniques followed by modified Zeihl Neelsen staining technique for the detection of different oocyst of the parasites. Statistical analysis performed included the Chi-square test and logistic regression. P>0.05 was considered significant.

Results: Out of the 97 HIV positive patients, 16/97(16.49%) were infected with opportunistic intestinal parasites. Out of the 208 negative participants, 40/208(19.4%) were infected. There was no significant association between the occurrence of opportunistic intestinal parasitic infections and HIV sero-status (OR=0.815; IC=0.410-1.620; p=0.559). The parasite species of Cryptosporidium parvum, Microsporidium, Cyclospora cayetanensis and Cycloisospora belli were detected in 38(12.5%); 11(3.6%); 4 (1.3%) and 3(1%) participants respectively in the overall population. Drinking water obtained from springs (OR=8.46; CI=1.56-14.34; p=0.00), boreholes (OR=3.129; CI=1.24-7.881; p=0.00) and wells (OR=4.01; CI=3.77-4.26; p=0.00) were associated to opportunistic parasitic infections. Opportunistic parasitic infections in HIV positive patients were not statistically associated with CD4 count, viral load, type and duration of antiretroviral therapy with respective p values of 0.15; 0.58; 0.08 and 0.54.

Conclusion: The study revealed that HIV positive individuals continue to experience gastrointestinal infections although antiretroviral therapy reduces the risk of parasitic infections. Regular screening and treatment of intestinal opportunistic parasitic infections coupled with Adherence to highly active antiretroviral therapy is very vital in improving the overall quality of care of HIV/AIDS patients.