Published October 28, 2021 | Version v1
Journal article Open

Intestinal Parasites and HIV Co-infections in Mogadishu (Somalia): A Retrospective Evaluation of Four-Year Follow-up Data

Creators

  • 1. Department of Infectious Disease and Clinical Microbiology, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.
  • 2. Department of Public Health, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.
  • 3. Department of Internal Medicine, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.
  • 4. Department of Medical Microbiology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
  • 5. Department of General Surgery, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.
  • 6. Department of Family Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
  • 7. Department Medical Biochemistry, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.
  • 8. Department of Medical Microbiology, Gulhane Medical Faculty, University of Health Sciences, Ankara, Turkey.
  • 9. Department of Infectious Disease, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
  • 10. Higher School of Health Sciences and Techniques, King Faisal University, N'Djamena, Chad.

Description

Abstract

This study aimed to evaluate the frequency and distribution characteristics of intestinal parasites and human immunodeficiency virus (HIV) seropositivity in children and adults presenting to a tertiary care hospital in Mogadishu, Somalia. The study included the results of all parasitological stool examinations conducted between November 2015 and November 2019. In addition, the HIV serological status of individuals was retrospectively analyzed. During the four-year study period, at least one intestinal parasite was found in stool samples from 1,538 (6.23%) of 24,676 individuals. A total of 1,570 intestinal parasites were detected in 1,538 patients (42.5% aged 10 years and under), including 44 parasites in mixed infections and 20 parasites in 10 patients at different times. The most common intestinal parasite was Giardia lamblia (n=730, 46.5%), followed by Entamoeba histolytica (n=677, 43.1%), Ascaris lumbricoides (n=30, 1.9%), Hymenolepis nana (n=28, 1.78%), Trichomonas hominis (n=26, 1.66%), Trichuris trichiura (n=26, 1.66%), and eight other species (n=53, 3.38%). HIV seropositivity was present in 1.12% (4/358) of the patients with parasitic infections and 0.39% (23/5868) of those with a negative stool test (p=0.0655). Intestinal parasitic infections increased in December and January. A. lumbricoides and T. trichiura were significantly increased in patients from refugee camps. This study included the most comprehensive data on the distribution and characteristics of intestinal parasitic infections and HIV seroprevalence in Somalia over the last 30 years. We consider that these data will contribute to the risk analysis and planning of preventive health policies.

Özet

Bu çalışmada Somali Mogadişu’da bulunan bir üçüncü basamak hastanesine başvuran çocuk ve yetişkinlerde intestinal parazitlerinin görülme sıklığı ve dağılım özellikleri ile insan immün yetmezlik virusu (HIV) seropozitifliğinin değerlendirilmesi amaçlanmıştır. Çalışma, Kasım 2015 ile Kasım 2019 arasında yapılan tüm parazitolojik dışkı incelemelerinin sonuçlarını içermektedir. Ek olarak, bireylerin HIV serolojik durumları retrospektif olarak incelenmiştir. Dört yıllık çalışma süresi boyunca, 24.676 kişiden 1.538'inin (%6.23) dışkı örneklerinde en az bir intestinal parazit varlığı bulundu. Çoklu enfeksiyonlarda 44 parazit ve 10 hastada farklı zamanlarda saptanan 20 parazit dahil olmak üzere 1.538 hastada (%42.5'i 10 yaş ve altı) toplam 1.570 intestinal parazit tespit edildi. En yaygın tespit edilen intestinal parazit Giardia lamblia 730 (%46.5) iken, diğerleri sırasıyla Entamoeba histolytica 677 (%43.1), Ascaris lumbricoides 30 (%1.9), Hymenolepis nana 28 (%1.78), Trichomonas hominis 26 (%1.66), Trichuris trichiura 26 (%1.66) ve diğer sekiz tür (n=53, %3.38) idi. Paraziter enfeksiyonu olan hastaların %1,12'sinde (4/358), dışkı testi negatif olanların ise %0,39'unda (23/5868) HIV seropozitifliği mevcuttu (p=0,0655). İntestinal parazit enfeksiyonları Aralık ve Ocak aylarında artmıştı. A. lumbricoides ve T. trichiura mülteci kamplarından gelen hastalarda önemli oranda yüksekti. Bu çalışma, Somali'de intestinal paraziter enfeksiyonların dağılımı ve özellikleri ile HIV seroprevalansı hakkında son 30 yıldaki en kapsamlı verileri içermektedir. Bu verilerin risk analizine ve koruyucu sağlık politikalarının planlanmasına katkı sağlayacağını düşünüyoruz.

Notes

Mogadişu'da (Somali) İntestinal Parazitler ve HIV Ko-enfeksiyonları: Dört Yıllık Takip Verilerinin Retrospektif Değerlendirmesi

Files

jmvi.2021.39.z.pdf

Files (980.7 kB)

Name Size Download all
md5:73541f314341ae6354fd43eab75e52de
980.7 kB Preview Download

Additional details

References

  • 1. Wong LW, Ong KS, Khoo JR, Goh CBS, Hor JW, Lee SM. Human intestinal parasitic infection: a narrative review on global prevalence and epidemiological insights on preventive, therapeutic and diagnostic strategies for future perspectives. Expert Rev Gastroenterol Hepatol 2020; 14(11): 1093-105.
  • 2. El-Sayed NM, Ramadan ME. The Impact of Intestinal Parasitic Infections on the Health Status of Children: An Overview. J Pediatr Infect Dis 2017; 12: 209-13.
  • 3. Jaran AS. Prevalence and seasonal variation of human intestinal parasites in patients attending hospital with abdominal symptoms in northern Jordan. East Mediterr Health J 2017; 22(10): 756-60.
  • 4. World Health Organization (WHO), Geneva, Switzerland. Prevention and control of intestinal parasitic infections: WHO Technical Report Series N° 749. Available at: https://apps.who.int/iris/handle/10665/41298. [Accessed September 28, 2021].
  • 5. Amer OSO, Al-Malki ES, Waly MI, AlAgeel A, Lubbad MY. Prevalence of Intestinal Parasitic Infections among Patients of King Fahd Medical City in Riyadh Region, Saudi Arabia: A 5-Year Retrospective Study. J Parasitol Res 2018; 2018: 8076274.
  • 6. Fletcher SM, Stark D, Harkness J, Ellis J. Enteric protozoa in the developed world: a public health perspective. Clin Microbiol Rev 2012; 25(3): 420-49.
  • 7. Yeshitila YG, Zewde H, Mekene T, Manilal A, Lakew S, Teshome A. Prevalence and Associated Risk Factors of Intestinal Parasites among Schoolchildren from Two Primary Schools in Rama Town, Northern Ethiopia. Can J Infect Dis Med Microbiol 2020; 2020: 5750891.
  • 8. Miller JM, Boyd HA, Ostrowski SR, Cookson ST, Parise ME, Gonzaga PS, et al. Malaria, intestinal parasites, and schistosomiasis among Barawan Somali refugees resettling to the United States: a strategy to reduce morbidity and decrease the risk of imported infections. Am J Trop Med Hyg 2000; 62(1): 115-21.
  • 9. Hesse AA, Nouri A, Hassan HS, Hashish AA. Parasitic infestations requiring surgical interventions. Semin Pediatr Surg 2012; 21(2): 142-50.
  • 10. Guerrant DI, Moore SR, Lima AA, Patrick PD, Schorling JB, Guerrant RL. Association of early childhood diarrhea and cryptosporidiosis with impaired physical fitness and cognitive function four-seven years later in a poor urban community in northeast Brazil. Am J Trop Med Hyg 1999; 61(5): 707-13.
  • 11. Koruk I, Simsek Z, Tekin Koruk S, Doni N, Gürses G. Intestinal parasites, nutritional status and physchomotor development delay in migratory farm worker's children. Child Care Health Dev 2010; 36(6): 888-94.
  • 12. Scaglia M, Gatti S, Bassi P, Viale PL, Novati S, Ranieri S. Intestinal co-infection by Cyclospora sp. and Cryptosporidium parvum: first report in an AIDS patient. Parasite 1994; 1(4): 387-90.
  • 13. Rodríguez-Pérez EG, Arce-Mendoza AY, Montes-Zapata ÉI, Limón A, Rodríguez LÉ, Escandón-Vargas K. Opportunistic intestinal parasites in immunocompromised patients from a tertiary hospital in Monterrey, Mexico. Infez Med 2019; 27(2): 168-74.
  • 14. Brown M, Mawa PA, Kaleebu P, Elliott AM. Helminths and HIV infection: epidemiological observations on immunological hypotheses. Parasite Immunol 2006; 28(11): 613-23.
  • 15. Dermauw V, Dorny P, Braae UC, Devleesschauwer B, Robertson LJ, Saratsis A, Thomas LF. Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in southern and eastern Africa. Parasit Vectors 2018; 11(1): 578.
  • 16. Rice JE, Skull SA, Pearce C, Mulholland N, Davie G, Carapetis JR. Screening for intestinal parasites in recently arrived children from East Africa. J Paediatr Child Health 2003; 39(6): 456-9.
  • 17. Schranz C. The acute medical management of detained Somali pirates and their captives. Mil Med 2012; 177(9): 1095-9.
  • 18. Peltola H, Kataja M, Mohamed ON, Kyrönseppä H. Intestinal parasitism of children and mothers in rural Somalia. Pediatr Infect Dis J 1988; 7(7): 488-92.
  • 19. Ilardi I, Sebastiani A, Leone F, Madera A, Bile MK, Shiddo SC, et al. Epidemiological study of parasitic infections in Somali nomads. Trans R Soc Trop Med Hyg 1987; 81(5): 771-2.
  • 20. Ilardi I, Shiddo SC, Mohamed HH, Mussa C, Hussein AS, Mohamed CS, et al. The prevalence and intensity of intestinal parasites in two Somalian communities. Trans R Soc Trop Med Hyg 1987; 81(2): 336-8.
  • 21. United Nations Children's Fund (UNICEF), New York City, US. Under-five mortality. Available at: https://data.unicef.org/topic/child-survival/under-five-mortality/ [Accessed September 28, 2021].
  • 22. Mulatu G, Zeynudin A, Zemene E, Debalke S, Beyene G. Intestinal parasitic infections among children under five years of age presenting with diarrhoeal diseases to two public health facilities in Hawassa, South Ethiopia. Infect Dis Poverty 2015; 4: 49.
  • 23. Yoseph A, Beyene H. The high prevalence of intestinal parasitic infections is associated with stunting among children aged 6-59 months in Boricha Woreda, Southern Ethiopia: a cross-sectional study. BMC Public Health 2020; 20(1): 1270.
  • 24. Abdalazim Hassan H, Abd Alla AB, Elfaki TEM, Saad MBEA. Frequencies of gastrointestinal parasites among students of primary school in Al Kalakla Locality, Khartoum State, Sudan: a cross-sectional study. F1000Res 2019; 8: 1719.
  • 25. The Central Intelligence Agency, Virginia, USA. The World Factbook. Available at: https://www.cia.gov/the-world-factbook/field/population [Accessed September 27, 2021].
  • 26. Saki J, Khademvatan S, Foroutan-Rad M, Gharibzadeh M. Prevalence of Intestinal Parasitic Infections in Haftkel County, Southwest of Iran. Int J Infect 2017; 4(4): e15593.
  • 27. Adıyaman Korkmaz G, Doğruman Al F, Mumcuoğlu İ. Investigation of the presence of Blastocystis spp. in stool samples with microscopic, culture and molecular methods. Mikrobiyol Bul 2015; 49(1): 85-97.
  • 28. Alfellani MA, Stensvold CR, Vidal-Lapiedra A, Onuoha ES, Fagbenro-Beyioku AF, Clark CG. Variable geographic distribution of Blastocystis subtypes and its potential implications. Acta Trop 2013; 126(1): 11-8.
  • 29. Ulusan Ö, Zorbozan O, Yetişmiş K, Töz S, Ünver A, Turgay N. The Distribution of the Intestinal Parasites Detected in Ege University Medical Faculty Parasitology Direct Diagnosis Laboratory; 10-Years Evaluation. Turk Mikrobiyoloji Cem Derg 2019; 49(2): 86-91.
  • 30. Doyle PW, Helgason MM, Mathias RG, Proctor EM. Epidemiology and pathogenicity of Blastocystis hominis. J Clin Microbiol 1990; 28(1): 116-21.
  • 31. Zorbozan O, Quliyeva G, Tunalı V, Özbilgin A, Turgay N, Gökengin AD. Intestinal Protozoa in Hiv-Infected Patients: A Retrospective Analysis. Turkiye Parazitol Derg 2018; 42(3): 187-90.
  • 32. Nkenfou CN, Nana CT, Payne VK. Intestinal parasitic infections in HIV infected and non-infected patients in a low HIV prevalence region, West-Cameroon. PLoS One 2013; 8(2): e57914.
  • 33. Scott DA, Corwin AL, Constantine NT, Omar MA, Guled A, Yusef M, et al. Low prevalence of human immunodeficiency virus-1 (HIV-1), HIV-2, and human T cell lymphotropic virus-1 infection in Somalia. Am J Trop Med Hyg 1991; 45(6): 653-9.
  • 34. Ali MK, Karanja S, Karama M. Factors associated with tuberculosis treatment outcomes among tuberculosis patients attending tuberculosis treatment centres in 2016-2017 in Mogadishu, Somalia. Pan Afr Med J 2017; 28: 197.
  • 35. The Central Intelligence Agency, Virginia, USA. The World Factbook. Available at: https://www.cia.gov/the-world-factbook/countries/somalia/ [Accessed September 27, 2021].
  • 36. Tahtabasi M, Mohamud Abdullahi I, Kalayci M, Gedi Ibrahim I, Er S. Cancer Incidence and Distribution at a Tertiary Care Hospital in Somalia from 2017 to 2020: An Initial Report of 1306 Cases. Cancer Manag Res 2020; 12: 8599-611.
  • 37. World Bank Group (WBG), Washington DC, USA. Climate Change Knowledge Portal, Somalia. Available at:https://climateknowledgeportal.worldbank.org/country/somalia/climate-data-historical [Accessed September 28, 2021].
  • 38. Food and Agriculture Organization (FAO). Food Security and Nutrition Analysis Unit - Somalia: January 2020 Monthly Rainfall and NDVI (Issued February 28, 2020). Available at:https://www.fsnau.org/publications [Accessed September 28, 2021].
  • 39. Speich B, Moser W, Ali SM, Ame SM, Albonico M, Hattendorf J, et al. Efficacy and reinfection with soil-transmitted helminths 18-weeks post-treatment with albendazole-ivermectin, albendazole-mebendazole, albendazole-oxantel pamoate and mebendazole. Parasit Vectors 2016; 9: 123.
  • 40. Mangoud AM. Effect of parasite screening on refugee health. J Egypt Soc Parasitol 2000; 30(1): 1-10. PMID: 10786014.
  • 41. Osman KA, Zinsstag J, Tschopp R, Schelling E, Hattendorf J, Umer A, et al. Nutritional status and intestinal parasites among young children from pastoralist communities of the Ethiopian Somali region. Matern Child Nutr 2020; 16(3): e12955.
  • 42. Leung PO, Chen KH, Chen KL, Tsai YT, Liu SY, Chen KT. Epidemiological features of intestinal infection with Entamoeba histolytica in Taiwan, 2002-2010. Travel Med Infect Dis 2014; 12(6 Pt A): 673-9.
  • 43. Food and Agriculture Organization (FAO). Food Security and Nutrition Analysis Unit - Somalia: Approximately 850 000 children likely to be acutely malnourished. Available at: https://www.fsnau.org/ [Accessed September 28, 2021].