Cryptosporidiosis among HIV positive patients in the North Rift region of Kenya.

Abstract

Introduction: Cryptosporidiosis is a gastrointestinal illness characterized by watery diarrhea and caused by protozoan parasites belonging to Cryptosporidium species. It occurs in both humans and animals. In immuno competent individuals the infection may resolve without intervention but in immuno-compromised individuals, it may persist to fatality. Objectives: To determine the prevalence of cryptosporidiosis, cryptosporidium genotypes and associated factors among HIV patients. Methods: This was a cross-sectional study, a total of 1794 stool samples were screened for Cryptosporidium oocysts, using modified ZN staining and parasite genotypes and sub-genotypes determined using PCR-RFLP analysis of the 18s RNA subunit and CP47 gene sequencing respectfully. Data was analyzed for measures of central tendency and statistical associations. Results: The prevalence of cryptosporidiosis was 3.2% (58/1794) with no significant sex-related differences in risk of infection with Cryptosporidium (OR=1.2130, 95% CI=0.6895-1.341, P=0.5023). C. hominis was the most common genotype followed by C. parvum and then C. meleagridis. About 1% of the samples had a mixed infection of C. hominis and C. parvum. Cryptosporidiosis significantly associated with diarrhea (OR= 4.7087, P≤0.0001), headache (OR=2.218, P= 0.0033), and skin rash (OR=2.2179, P=0.0279). Conclusion: The prevalence of cryptosporidiosis among HIV positive was of 3.2% and within the range of 3- 4% reported in other parts of Kenya and within the East African region. Diarrhea, headache, low CD4 counts and skin rash were significantly associated with Cryptosporidium infection.