title: Identification and characterization of microsporidia from fecal samples of HIV-positive patients from Lagos, Nigeria.
abstract: BACKGROUND
  Microsporidia are obligate intracellular parasites that infect a broad range of vertebrates and invertebrates. They have been increasingly recognized as human pathogens in AIDS patients, mainly associated with a life-threatening chronic diarrhea and systemic disease. However, to date the global epidemiology of human microsporidiosis is poorly understood, and recent data suggest that the incidence of these pathogens is much higher than previously reported and may represent a neglected etiological agent of more common diseases indeed in immunocompetent individuals. To contribute to the knowledge of microsporidia molecular epidemiology in HIV-positive patients in Nigeria, the authors tested stool samples proceeding from patients with and without diarrhea.
  
  
  RESULTS
  Stool samples from 193 HIV-positive patients with and without diarrhea (67 and 126 respectively) from Lagos (Nigeria) were investigated for the presence of microsporidia and Cryptosporidium using Weber's Chromotrope-based stain, Kinyoun stain, IFAT and PCR. The Weber stain showed 45 fecal samples (23.3%) with characteristic microsporidia spores, and a significant association of microsporidia with diarrhea was observed (O.R. = 18.2; CI: 95%). A similar result was obtained using Kinyoun stain, showing 44 (31,8%) positive samples with structures morphologically compatible with Cryptosporidium sp, 14 (31.8%) of them with infection mixed with microsporidia. The characterization of microsporidia species by IFAT and PCR allowed identification of Enterocytozoon bieneusi, Encephalitozoon intestinalis and E. cuniculi in 5, 2 and 1 samples respectively. The partial sequencing of the ITS region of the rRNA genes showed that the three isolates of E.bieneusi studied are included in Group I, one of which bears the genotype B.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report of microsporidia characterization in fecal samples from HIV-positive patients from Lagos, Nigeria. These results focus attention on the need to include microsporidial diagnosis in the management of HIV/AIDS infection in Nigeria, at the very least when other more common pathogens have not been detected.
authors.affiliation: Department of Zoology, Faculty of Science, Lagos State University, Ojo, Lagos, Nigeria.
authors.forename: Oladele Teslim
authors.initials: OT
authors.lastname: Ojuromi
authors.forename: Fernando
authors.initials: F
authors.lastname: Izquierdo
authors.forename: Soledad
authors.initials: S
authors.lastname: Fenoy
authors.forename: Adetayo
authors.initials: A
authors.lastname: Fagbenro-Beyioku
authors.forename: Wellington
authors.initials: W
authors.lastname: Oyibo
authors.forename: Alani
authors.initials: A
authors.lastname: Akanmu
authors.forename: Nkiruka
authors.initials: N
authors.lastname: Odunukwe
authors.forename: Nuno
authors.initials: N
authors.lastname: Henriques-Gil
authors.forename: Carmen
authors.initials: C
authors.lastname: del Aguila
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D000328:Adult; D003457:Cryptosporidiosis / Q000175:diagnosis; D003458:Cryptosporidium / Q000235:genetics / Q000302:isolation & purification; D003967:Diarrhea / Q000382:microbiology / Q000469:parasitology; D005243:Feces / Q000382:microbiology* / Q000469:parasitology; D005260:Female; D020459:Genes, rRNA; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D016814:Microsporidia / Q000145:classification / Q000302:isolation & purification*; D016881:Microsporidiosis / Q000453:epidemiology*; D008875:Middle Aged; D009549:Nigeria