Journal
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE
Volume 107, Issue 10, Pages 631-638Publisher
OXFORD UNIV PRESS
DOI: 10.1093/trstmh/trt078
Keywords
HIV/AIDS; Diarrhoea; Enteric pathogens; Isospora; Cryptosporidium; Shigella
Funding
- Fogarty International Clinical Research Fellowship [R24 TW007988]
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Background: Diarrhoea is a significant cause of morbidity and mortality in immunocompromised patients. The objectives of this study were to investigate the aetiological agents, risk factors and clinical features associated with diarrhoea in HIV/AIDS patients in Kenya. Methods: Sociodemographic, epidemiological and clinical data were obtained for 164 HIV/AIDS patients (70 with and 94 without diarrhoea) recruited from Kenyatta National Hospital, Kenya. Stool samples were examined for enteric pathogens by microscopy and bacteriology. Results: Intestinal protozoa and fungi were identified in 70% of patients, more frequently in those with diarrhoea (p<0.001). Helminths were detected in 25.6% of patients overall, and bacterial pathogens were identified in 51% of patients with diarrhoea. Polyparasitism was more common in patients with diarrhoea than those without (p<0.0001). Higher CD4(+) T-cell count (OR = 0.995, 95% CI 0.992-0.998) and water treatment (OR = 0.231, 95% CI 0.126-0.830) were associated with a lower risk of diarrhoea, while close contact with cows (OR = 3.200, 95% CI 1.26-8.13) or pigs (OR = 11.176, 95% CI 3.76-43.56) were associated with a higher risk of diarrhoea. Conclusions: Multiple enteric pathogens that are causative agents of diarrhoea were isolated from stools of antiretroviral therapy-naive HIV/AIDS patients, indicating a need for surveillance, treatment and promotion of hygienic practices.
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