Prevalence, Predisposing Factors, and Indicators of Cryptosporidium Infection among HIV Patients in Kisumu County, Kenya
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Date
2021
Authors
Otieno, Onjore Samwel
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Cryptosporidium species causes increased morbidity and mortality among AIDS patients worldwide particularly in third world countries where antiretroviral therapy (ARTs) are scarce and unaffordable. In Kenya, approximately 4.9 % people live with HIV/AIDS and 15million are on ART. Cryptosporidium has been reported as the leading indicator of fatalities among HIV/AIDS patients. There is very scanty information on prevalence, predisposing factors and indicators, for Cryptosporidium infection in people living with HIV/AIDS. Secondly documentation on CD4T-cells count, leucocyte counts among HIV patients with Cryptosporidium infection is lacking. This study therefore sought to investigate the prevalence, predisposing factors, and indicators for Cryptosporidium infection among HIV patients Kisumu county, Kenya. The study adopted a health facility based cross-sectional analytical study where a total 344 HIV/AIDS patients were recruited. Participants in the study provided stool samples for Cryptosporidium oocysts microscopic examination and blood for CD4+cell T-cells counts and full haemogram for leucocytes cell counts. Cryptosporidium species was identified through microscopy. Logistic regression was used to assess association between Cryptosporidium infection and possible risk factors. The OR, CI at 95% and p<0.05 were used to check the likelihood of exposure. The study results indicated Cryptosporidium infection prevalence at 63.1% among HIV/AIDS patients by microscopy. It was observed that, HIV patients with CD4+<200 cells/mm3 blood were more at risk of being infected with Cryptosporidium unlike patients with >700 cells/mm3blood (p<0.05). Further, with respect to risk factors patients with low WBC were at increased risk of infection with Cryptosporidium compared to those with high WBC count (95% CI=1.21-3.91, OR=1.67; p=0.031) and HIV positive persons with low platelet counts were at higher risk of infection with Cryptosporidium in contrast to those with high platelet counts (OR=1.41;95% CI1.13-2.04; p=0.004). Multivariate logistic regression depicted that male respondent were less exposed to Cryptosporidium infection compared to female (95% CI 0.33-0.90, OR=0.54; P=0.017). There was no association between Cryptosporidium infection and age among HIV patients. The respondents who had watery or soft stool were more likely to have cryptosporidiosis compared to those who had hard stool (P<0.001) in contrast to soft stool (95%CI=1.87-7.56; OR=3.77; P<0.001). Similarly, those who had CD4+ counts< 200, 200-350 and 350-700 were more likely to have cryptosporidiosis compared to those with CD4 counts >700 (95% CI1.56-6.29; OR=3.16; P=0.001), (95%CI 1.01-4.53; OR=2.15; P=0.045) and (95% CI=1.00; -3.24.; OR=1.81 P=0.047). The respondents who had low white blood cells (95% CI =1.00-3.91; OR=1.67; P=0.031) were more likely to have cryptosporidiosis compared to those who had high white blood cells. Similarly, those with low platelets (95% CI=1.113-2.04; OR=1.41; P=0.004) were more likely to have cryptosporidiosis compared to those with high platelet count. From the study, it was concluded that, low CD4+T-cells counts, and gender were some of the predisposing factors that make people susceptible to Cryptosporidium infections. The study recommends regular screening for Cryptosporidium spp in order to manage Cryptosporidiosis co-infection amongst HIV positive patients effectively.
Description
A Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Science (Applied Medical Parasitology) in the School of Pure and Applied Science, Kenyatta University, May 2021
Keywords
Prevalence, Predisposing Factors, Indicators, Cryptosporidium Infection, HIV Patients, Kisumu County, Kenya