Aim To investigate the prevalence of Cryptosporidium sp. and B. hominis among human immunodeficiency virus (HIV) positive patients in two different outpatient clinics, Haji Adam Malik General Hospital and Primary Care Centre of Padang Bulan, Medan, Indonesia, between two interval periods. Method Cryptosporidium spp. microscopic examination, as well as Jones’ medium for B. hominis, were conducted in the Parasitology Laboratory, enzyme-linked immunosorbent assay (ELISA) was done in the Multidisciplinary Laboratory, Faculty of Medicine, Universitas Sumatera Utara. This was a cross-sectional study, involving 54 diarrheic HIV positive patients (44 males, 10 females). The data were analysed by Spearmen rank correlation, interrater agreement, and 2 tests. Results Infection rate for Cryptosporidium spp. and B. hominis was 24% (13 patients) and 9% (five patients), respectively. The prevalence of CD4 cell count below 200 cell/mm3 was relatively high, 29.6% (16 patients). There was a significant relationship between cryptosporidiosis and CD4 cell count (p=0.01; OR 1.57; 95% CI 1.25-1.99). Microscopic examination was superior over ELISA, whose diagnostic value for sensitivity and specificity was 46.15% and 100.0%, respectively, and Kappa (K) coefficient of 0.56. Conclusion The prevalence of cryptosporidiosis among HIV patients was still relatively high. CD4 count showed a significant relationship with Cryptosporidium spp. infection, but not with Blastocystic hominis. Microscopic examination is still the most reliable technique to diagnose the parasites in faecal samples.
Roberts T, Stark D, Harkness J, Ellis J. Update on the pathogenic potential and treatment options for Blastocystis sp. Gut Pathog 2014:1–9.
2
Kurniawan A, Karyadi T, Dwintasari S, Sari I, Yunihastuti E, Djauzi S, et al. Intestinal parasitic infections in HIV/AIDS patients presenting with diarrhoea in Jakarta. Indonesia Trans R Soc Trop Med Hyg 2009:892–8.
3
Beyhan Y, Yilmaz H, Cengiz Z, Ekici A. Clinical significance and prevalence of Blastocystis hominis in Van, Turkey. Saudi Med J 2015:1118–21.
4
Yang Y, Zhou Y, Xiao P, Shi Y, Chen Y, Liang S, et al. Prevalence of and risk factors associated with Cryptosporidium infection in an underdeveloped rural community of Southwest China. Infect Dis Poverty 2017:1–10.
5
Pantenburg B, Cabada M, White A. Treatment of cryptosporidiosis. Exp Rev Anti Infect Ther 2009:385–91.
6
Sponseller J, Griffiths J, Tzipori S. The evolution of respiratory Cryptosporidiosis: evidence for transmission by inhalation. Clin Microbiol Rev 2014:575–86.
7
Reina F, Ribeiro C, De Araujo R, Matte M, Castanho R, Tanaka I, et al. Intestinal and pulmonary infection by Cryptosporidium parvum in two patients with HIV/AIDS. Rev Inst Med Trop Sao Paulo 2016:21.
8
Hawkins S, Thomas R, Teasdale C. Acute pancreatitis: a new finding in cryptosporidium enteritis. Br Med J 1987:483–4.
9
Naseer M, Dailey F, Juboori A, Samiullah S, Tahan V. Epidemiology, determinants, and management of AIDS cholangiopathy: a review. World J Gastroenterol 2018:767–74.
10
Darlan D, Rozi M, Andriyani Y, Yulfi H, Saragih R, Nerdy N, et al. Findings and its symptomatology among immunocompromised patients. Open Access Maced J Med Sci 2019:1567–71.
11
Certad G, Viscogliosi E, Chabé M, Cacciò S. Pathogenic mechanisms of Cryptosporidium and Giardia. Trends Parasitol 2017:561–76.
12
Borad A, Ward H. Human immune responses in cryptosporidiosis. Future Microbiol 2010:507–19.
13
Adamu H, Wegayehu T, Petros B. High prevalence of diarrhoegenic intestinal parasite infections among non-ART HIV patients in Fitche Hospital. Ethiopia PLoS One 2013:72634.
14
Puthia M, Sio S, Lu J, Tan K. Blastocystis ratti induces contact-independent apoptosis, F-actin rearrangement, and barrier function disruption in IEC-6 Cells. Infect Immun 2006:4114–23.
15
Jeremiah S, Parija S. Blastocystis: taxonomy, biology and virulence. Trop Parasitol 2013:17.
16
Danišová O, Halánová M, Valenčáková A, Luptáková L. Sensitivity, specificity and comparison of three commercially available immunological tests in the diagnosis of Cryptosporidium species in animals. Brazilian J Microbiol 2018:177–83.
17
Marques F, Cardoso L, Cavasini C, Almeida D, Bassi M, N, et al. Performance of an immunoenzymatic assay for Cryptosporidium diagnosis of fecal samples. Brazilian J Infect Dis 2005:3–5.
18
Hawash Y. Evaluation of an immunoassay-based algorithm for screening and identification of Giardia and Cryptosporidium antigens in human faecal specimens from Saudi Arabia. J Parasitol Res 2014.
19
El-Sayed N, Wahab A, M. Detection of blastocystis in stool specimens using parasitological methods and commercial antigen detection enzymelinked immunosorbent assay: a comparative study. Egypt J Med Sci 2011:327–38.
20
Gawad S, Ismail M, Imam N, Eassa A, Sarea E. Detection of Cryprosporidium spp. in diarrheic immunocompetent patients in Beni-Suef, Egypt: insight into epidemiology and diagnosis. Korean. J Parasitol 2018:113–9.
21
El-Sayed N, Wahab A, M. Detection of Blastocystis in stool specimen using parasitological methods and commercial antigen detection enzymelinked immunosorbent assay: a comparative study. Egypt J Med Sci 2011:327–38.
22
Nydam D, Lindergard G, Guard C, Schaaf S, Wade S, Ho M. Serological detection of exposure to Cryptosporidium parvum in cattle by ELISA and its evaluation in relation to coprological tests. Parasitol Res 2002:797–803.
23
Santosh K, A. Microbiological stool examination: Overview. J Clin Diagnostic Res 2012:503–9.
24
Badparva E, Ezatpour B, Mahmoudvand H, Behzadifar M, Behzadifar M, Kheirandish F. Prevalence and genotype analysis of Blastocystis hominis in Iran: a systematic review and meta-analysis. Arch Clin Infect Dis 2017:1–9.
25
Rossle N, Latif B. Cryptosporidiosis as threatening health problem: a review. Asian Pac J Trop Biomed 2013:916–24.
26
Ahmadpour E, Safarpour H, Xiao L, Zarean M, Hatam-Nahavandi K, Barac, et al. Cryptosporidiosis in HIV-positive patients and related risk factors: a systematic review and meta-analysis. Parasite 2020:27.
27
Bhalchandra S, Cardenas D, Ward H. Recent breakthroughs and ongoing limitations in Cryptosporidium research. F1000Res 2018:1–9.
28
Bouzid M, Hunter P, Chalmers R, Tyler K. Cryptosporidium pathogenicity and virulence. Clin Microbiol Rev 2013:115–34.
29
Utami W, Murhandarwati E, Artama W. Kusnanto H. Cryptosporidium infection increases the risk for chronic diarrhea among people living with HIV in Southeast Asia: a review and meta-analysis. Asia Pac J Public Health 2020:8–18.
30
Khalil S, Mirdha B, Sinha S, Panda A, Singh Y, Joseph A, et al. Intestinal parasitosis in relation to anti-retroviral therapy. CD n.d.
31
T-cell count and diarrhea in HIV patients. Korean J Parasitol 2015:705–12.
32
Tan K. New insights on classification, identification, and clinical relevance of Blastocystis spp. Clin Microbiol Rev 2008:639–65.
33
Wawrzyniak I, Poirier P, Texier C, Delbac F, Viscogliosi E, Dionigia M, et al. an unrecognized parasite: an overview of pathogenesis and diagnosis. Ther Adv Infect Dis 2013:167–78.
34
Lepczyńska M, Białkowska J, Dzika E, Piskorz-Ogórek K, Korycińska J. Blastocystis: how do specific diets and human gut microbiota affect its development and pathogenicity? Eur J Clin Microbiol Infect Dis 2017:1531–40.
35
Zierd C. Blastocystis hominis -Past and Future. Clin Microbiol Rev 1991:61–79.
36
Vanathy K, Parija S, Mandal J, Hamide A, Krishnamurthy S. Cryptosporidiosis: a mini review. Trop Parasitol 2017:72–80.
37
Casemore D, Armstrong M, Sands R. Laboratory diagnosis of Cryptosporidiosis. J Clin Pathol 1985:1337–41.
38
Hok T. A Simple and Rapid Cold-Staining Method for Acid-fast. Am J Respir Crit Care Med 1962:753–4.
39
Padukone S, Mandal J, Rajkumari N, Bhat B, Swaminathan R, Parija S. Detection of Blastocystis in clinical stool specimens using three different methods and morphological examination in Jones’ medium. Trop Parasitol 2018:33–40.
40
Wijayanti T. Kriptosporidiosis di Indonesia (Cryptosporidiosis in Indonesia). Balaba 2017:73–82.
41
Wahdini S, Kurniawan A, Yunihastuti E. Deteksi Koproantigen Cryptosporidium sp pada Pasien HIV/ AIDS dengan Diare Kronis (Detection of Cryptosporidium sp. coproantigen in HIV/AIDS patients with chronic diarrhea). EJournal Kedokt Indones 2016:49–53.
42
Torgerson P, Devleesschauwer B, Praet N, Speybroeck N, Willingham A, Kasuge F, et al. World Health Organization estimates of the globarl and regional disease burden of 11 foodbourne parasitic diseases, 2010: a data synthesis. PLoS Med 20154:1001920.
43
Mackey T, Liang B, Cuomo R, Hafen R, Brouwer K, De L. Emerging and reemerging neglected tropical diseases: a review of key characteristics, risk factors, and the policy and innovation environment. Clin Microbiol Rev 2014:949–79.
44
Hailemariam G, Kassu A, Abebe G, Abate E, Damte D, Mekonnen E, et al. Intestinal parasitic infections in HIV/AIDS and HIV seronegative individuals in a teaching hospital. Ethiopia Jpn J Infect Dis 2004:41–3.
45
Alemu A, Shiferaw Y, Getnet G, Yalew A, Addis Z. Opportunistic and other intestinal parasites among HIV/AIDS patients attending Gambi higher clinic in Bahir Dar City, North West Ethiopia. Asian Pac J Trop Med 2011:661–5.
46
Zali M, Mehr A, Rezaian M, Meamar A, Vaziri S, Mohraz M. Prevalence of intestinal parasitic pathogens among HIV-positive individuals in Iran. Jpn J Infect Dis 2004:268–70.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
,
