title: A cross-sectional serological study of cysticercosis, schistosomiasis, toxocariasis and echinococcosis in HIV-1 infected people in Beira, Mozambique.
abstract: BACKGROUND
  Helminthic infections are highly endemic in Mozambique, due to limited access to healthcare and resources for disease prevention. Data on the subclinical prevalence of these diseases are scarce due to the fact that an immunological and imaging diagnosis is not often available in endemic areas. We conducted a cross-sectional study on HIV1(+) patients from Beira city in order to determine the seroprevalence of cysticercosis, schistosomiasis, toxocariasis and echinoccocosis and its possible interaction with HIV infection.
  
  
  RESULTS
  Patients (601) were voluntarily recruited at the Ponta Gea Health Center and their demographic and clinical data were recorded (including CD4(+) cell count and antiretroviral regimen). Mean age was 39.7 years, 378 (62.9%) were women and 223 (37.1%) were men. Four hundred seventy-five (475) patients (79%) were already on highly active antiretroviral therapy (HAART), and 90 started therapy after being enrolled in the study. For serological testing we used a Multiplex Western Blot IgG from LDBIO Diagnostics. The overall seroprevalence was 10.2% for cysticercosis, 23% for schistosomiasis, 7.3% for toxocariasis and 17.3% for echinococcosis.
  
  
  CONCLUSIONS
  Neither age nor the CD4(+) count were significantly associated with the seroprevalence of the helminths studied. However, patients with CD4(+) between 200-500/µl had a higher seroprevalence to all helminths than those with less than 200/µl cells/and those with more than 500 cells/µl. Female gender was significantly associated with cysticercosis and schistosomiasis, and being in HAART with toxocariasis. Headache was significantly associated with cysticercosis and toxocariasis. There was no association between epilepsy and seropositivity to any of the parasites. The study concluded that a clear understanding of the prevalence and manifestations of these coinfections, how best to diagnose subclinical cases, and how to manage diseases with concomitant antiretroviral therapy is needed.
authors.affiliation: Department of Microbiology, Universidade Eduardo Mondlane, Maputo, Mozambique; Department of Medicine, University of California, San Diego, San Diego, California, United States of America.
authors.forename: Emilia Virginia
authors.initials: EV
authors.lastname: Noormahomed
authors.affiliation: Department of Microbiology, Universidade Eduardo Mondlane, Maputo, Mozambique.
authors.forename: Noémia
authors.initials: N
authors.lastname: Nhacupe
authors.affiliation: Department of Parasitology, Universidad de Granada, Granada, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Mascaró-Lazcano
authors.affiliation: Beira Central Hospital, Ministry of Health, Beira, Mozambique.
authors.forename: Manuel Natane
authors.initials: MN
authors.lastname: Mauaie
authors.affiliation: Department of Microbiology, Universidade Eduardo Mondlane, Maputo, Mozambique.
authors.forename: Titos
authors.initials: T
authors.lastname: Buene
authors.affiliation: Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
authors.forename: Carlos Abel
authors.initials: CA
authors.lastname: Funzamo
authors.affiliation: Department of Medicine, University of California, San Diego, San Diego, California, United States of America.
authors.forename: Constance Ann
authors.initials: CA
authors.lastname: Benson
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001569:Benzodiazepines; D000078306:Clobazam; D060085:Coinfection; D003430:Cross-Sectional Studies; D003551:Cysticercosis / Q000150:complications* / Q000453:epidemiology; D004443:Echinococcosis / Q000150:complications / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D009073:Mozambique / Q000453:epidemiology; D015995:Prevalence; D012552:Schistosomiasis / Q000150:complications* / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D014120:Toxocariasis / Q000150:complications* / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents; D001569:Benzodiazepines; D000078306:Clobazam