title: Intestinal parasites infections in hospitalized AIDS patients in Kinshasa, Democratic Republic of Congo.
abstract: To determine the prevalence and the species spectrum of intestinal parasites (IP) involved in hospitalized AIDS patients, a prospective observational and cross-sectional study was carried out in the four main hospitals in Kinshasa, Democratic Republic of the Congo. From November 2006 through September 2007, a single stool sample was collected from 175 hospitalized AIDS patients older than 15 years. Parasites were detected by light microscopy, including Ziehl-Neelsen, Fungi-Fluor, modified trichrome stains, and by immunofluorescence antibody tests and PCR for species diagnosis of microsporidia. At baseline, 19 patients (10.8%) were under antiretroviral therapy and 156 (89.2%) were eligible for ART. The main diagnosis for justifying hospitalization was intestinal infection associated with diarrhea in 87 out of 175 (49.7%). 47 out of 175 (26.9%) were found to harbor an IP, and 27 out of 175 (15.4%) were infected with at least one opportunistic IP (OIP). Prevalence rate for OIP were 9.7%, 5.1%, 1.7% and 0.6% for Cryptosporidium sp., Enterocytozoon bieneusi, Isospora belli and Encephalitozoon intestinalis respectively. Considering patients with diarrhea only, prevalence rate were 12.6%, 4.6%, 3.4% and 1.1% respectively. The other IP observed were Entamoeba histolytica/Entamoeba dispar in nine cases (5.1%), Ascoris lumbricoides in seven cases (4.0%), Giardia intestinalis in three cases (1.7%), hookworm in two cases (1.1%) and Trichiuris trichiura, Enterobius vermicularis, Schistosoma mansoni in one patient each (0.6%). No significant relationship was established between any individual IP and diarrhea. These results underline the importance of OIP in symptomatic AIDS patients regardless of diarrhea at the time of the hospitalisation, and showed that routine microscopic examination using stains designed for Cryptosporidium spp. or the microsporidia should be considered due to the absence of clinical markers.
authors.affiliation: Department of Tropical Medicine, Infectious Diseases, Division of Parasitology, University of Kinshasa, DR of the Congo. rogerwumba@yahoo.fr
authors.forename: R
authors.initials: R
authors.lastname: Wumba
authors.forename: B
authors.initials: B
authors.lastname: Longo-Mbenza
authors.forename: M
authors.initials: M
authors.lastname: Mandina
authors.forename: Wobin T
authors.initials: WT
authors.lastname: Odio
authors.forename: S
authors.initials: S
authors.lastname: Biligui
authors.forename: J
authors.initials: J
authors.lastname: Sala
authors.forename: J
authors.initials: J
authors.lastname: Breton
authors.forename: M
authors.initials: M
authors.lastname: Thellier
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy / Q000469:parasitology*; D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D003967:Diarrhea / Q000469:parasitology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007410:Intestinal Diseases / Q000453:epidemiology / Q000469:parasitology*; D008297:Male; D008875:Middle Aged; D010272:Parasitic Diseases / Q000453:epidemiology*; D015995:Prevalence
chemical_list: D044966:Anti-Retroviral Agents