title: Infectious diarrhoea in antiretroviral therapy-naive HIV/AIDS patients in Kenya.
abstract: 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-naïve HIV/AIDS patients, indicating a need for surveillance, treatment and promotion of hygienic practices.
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA.
authors.forename: Jane W
authors.initials: JW
authors.lastname: Wanyiri
authors.forename: Henry
authors.initials: H
authors.lastname: Kanyi
authors.forename: Samuel
authors.initials: S
authors.lastname: Maina
authors.forename: David E
authors.initials: DE
authors.lastname: Wang
authors.forename: Paul
authors.initials: P
authors.lastname: Ngugi
authors.forename: Roberta
authors.initials: R
authors.lastname: O'Connor
authors.forename: Timothy
authors.initials: T
authors.lastname: Kamau
authors.forename: Tabitha
authors.initials: T
authors.lastname: Waithera
authors.forename: Gachuhi
authors.initials: G
authors.lastname: Kimani
authors.forename: Claire N
authors.initials: CN
authors.lastname: Wamae
authors.forename: Mkaya
authors.initials: M
authors.lastname: Mwamburi
authors.forename: Honorine D
authors.initials: HD
authors.lastname: Ward
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000469:parasitology; D005243:Feces / Q000382:microbiology* / Q000469:parasitology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012499:Sanitation / Q000592:standards; D014881:Water Supply / Q000592:standards
keywords: Cryptosporidium; Diarrhoea; Enteric pathogens; HIV/AIDS; Isospora; Shigella
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