Prevalence and pattern of soil transmitted intestinal helminth infections amongst HIV infected children in a tertiary hospital south eastern, Nigeria

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Joseph Ezeogu
Jude Okoro

Abstract

Objective: Soil-transmitted helminth infections (STHI) coexist with human immunodeficiency virus (HIV) infection, and they are widespread in environments where poverty is endemic. Helminths upregulate immunological stimulation while HIV’s effect is down-regulatory, depicted by the increased incidence of hypersensitivity drug reactions in advanced HIV/AIDS. Hypobiosis (a state of dormancy in the host with the capability of reactivation and establishing intestinal infection over long periods) among helminths is accentuated in the presence of a low CD4 count. This makes HIV-positive patients often have a higher load of helminths. The study sought to determine the pattern, prevalence, and specie specific prevalence of intestinal helminthiasis in children living with HIV and HIV seronegative controls.


Material and Methods: This was a comparative cross-sectional study, conducted amongst 256 sero-positive children, and 268 matched controls recruited into the study between October and December 2022. Subjects were excluded if they had been given any antihelminth in the six weeks preceding enrollment. Data were collected using a structured interviewer-administered questionnaire. Fresh stool samples were analyzed using the Kato-Katz method.


Results: The prevalence of intestinal helminthiasis in children living with HIV was 47.7% and 36.6% amongst the sero-negative control population (p = 0.7589). Among the subjects and controls, the highest prevalence was seen in the 5-9 year age group, while those over 15 years had the lowest prevalence. These differences in the prevalence of helminths infection amongst the various age groups were significant in the subjects only and not in the controls. Of all the STHI, Hookworm infection constituted the majority 52.5%.  Multiple STHI were seen in 20.7% of subjects living with HIV, while 9.3% were seen in the control. The difference is statistically significant (p = .00003).


Conclusion: Soil-transmitted helminthic infection is more prevalent in children living with HIV than in apparently healthy children. Regular deworming should be considered in the care of children living with HIV.

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How to Cite
Ezeogu, J., & Okoro, J. (2023). Prevalence and pattern of soil transmitted intestinal helminth infections amongst HIV infected children in a tertiary hospital south eastern, Nigeria. Medical Science and Discovery, 10(6), 393–399. https://doi.org/10.36472/msd.v10i6.957
Section
Research Article
Received 2023-06-01
Accepted 2023-06-14
Published 2023-06-18

References

WHO Global Health Observatory. Summary of the global HIV epidemic. [Internet]. Available from: https://www.who.int/data/gho/data/themes/hiv-aids.

Benn Sartorius, Jorge Cano, Hope Simpson, Lucy S Tusting, Laurie B Marczak, Molly K Miller-Petrie, et al. Prevalence and intensity of soil-transmitted helminth infections of children in sub-Saharan Africa, 2000–18: a geospatial analysis. Lancet Glob Health. 2021;9:e52–60.

National Agency for the Control of AIDS (NACA). Nigeria Prevalence Rate 2019. [Internet]. Available from: https;//naca.gov.ng/Nigeria-prevalence rate.

Salome P, Yap SG, Gause WC. Effect of helminth-induced immunity on infections with microbial pathogens. Nat Immunol. 2013 Nov;14(11):1118-1126.

WHO newsroom at who.int/news-room/factsheets/details January 2022. Accessed 16/2/23.

Dahal SA, Francis OE, Francis EJ, Wamfas IF. Soil-transmitted helminths and associated risk factors among elementary school pupils in Dadin Kowa Jos. Niger Med J. 2015.

Kashima SN. Prevalence and distribution of soil-transmitted helminths infections in Nigerian children: a systematic review and meta-analysis. Infect Dis Poverty. 2018;7(69). https://doi.org/10.1186/340249-018-0451-2.

Isaac C, Teray PN, Inegbonsun CU, Ezekiel SA, Adamu HO, Ohiolei JA. Prevalence of soil-transmitted helminths infection at Primary School playground in Edo State, Southern Nigeria. Helminthologia. 2019;56(4):282-295.

Odinaka KK, Nwolisa CE, Mbanefo FN, Iheakaram CA, Okolo S. Prevalence and pattern of soil-transmitted helminths infection among primary school children in a rural community in Imo State. J Trop Med. 2015. 349439. https://doi.org/10.1155/2015/349439.

Mkhize BT, Mabaso M, Mamba T, Napier CE, Mkiza-Kwitshana ZC. The interaction between HIV and intestinal helminth parasites: co-infection with nutrition among adults in KwaZulu-Natal, South Africa. Biomed Res Int. 2017. https://doi.org/10.1155/2017/9059523.

Cooper P. Mucosal Immunology of Geohelminths infections in humans. Mucosal Immunol. 2009;2:288-299. https://doi.org/10.1038/mi.2009.14.

Karp CL, Auwaerter PG. Coinfection with HIV and Tropical Infectious Diseases. II Helminthic Fungal, Bacterial, and Viral Pathogens. HIV AIDS. 2007;45:1208-1213.

Clerici M, Declich S. African Enigma: Key Player in Human Immunodeficiency Virus Pathogenesis in Developing Countries? Clin Diagn Lab Immunol. 2001;8(5):864-866.

Bourke CD, Maizels RM, Mutapi F. Acquired immune heterogeneity and its sources in human helminth infection. Parasitology. 2011;138(2):139-159.

Iwuji MC, Ibe CP, Njoku JD, Anyanwu SO, Amangabara GT, Ac-Chukwuocha N, et al. Analysis of land use and land cover dynamics in Orlu Nigeria. Asian J Env and Eco. 2017;4(4):1-10.

Kirkwood BR. Essential medical statistics. 2nd ed. Malden, Mass: Blackwell Science; 2003. p. 420.

Orji ML, Onyire BN, Ibe B, Ibekwe R. Prevalence and intensity of Helminths infection in human immunodeficiency virus-infected children in Abakaliki, Ebonyi State, South East Nigeria. IOSR J Dent Med Sci. 2017;16:81-86.

Mwambete KD, Tunzo J, Temu-Justin M. Prevalence and management of Helminthiasis among under-fives living with HIV/AIDS at Amana Hospital Tanzania. J Int Assoc Providers AIDS Care. 2012;12(2):122-127.

2025 AIDS Targets: 2025 Target setting and 2020-2030 resource needs and impact estimation. UNAIDS. Accessed March 8, 2021. http://www.unaids.org/en/topics/2025_target_setting.

Salawu SA, Asaolu SO, Sowemimo AO. Co-infections with S. haematobium and STH among school-aged children in Saki, Oyo state. J Public Health Epidemiol. 2014;6(12):417-423.

Wagbatsoma VA, Ogbaini E, Esene H, Ibadin K. HIV Seropositivity and intestinal helminthiasis among children in a tertiary health facility in Benin City, Nigeria. Niger Med Pract. 2010;57:10-16.

Morawski BM, Yunus M, Kadho E, Turyasingura G, Barbra L, Ojok MA. Hookworm infection is associated with decreased CD4+ T cells counts in HIV-infected adults in Uganda. PLoS Negl Trop Dis. 2017;11(5):e0005634.

Sumbele IUN, Otia OV, Bopda OSM, et al. Polyparasitism with Schistosoma haematobium, Plasmodium, and soil-transmitted helminths in school-aged children in Muyuka, Cameroon following implementation of control measures: a cross-sectional study. Infect Dis Poverty.

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