Prevalence, socio-demographic factors and the relationship between cd4 count and infection with cryptosporidium parvum among hiv/aids infected patients with diarrhea in jos university teaching hospital, nigeria

Abstract

Cryptosporidium parvum is a clinically important opportunistic protozoan parasite that causes chronic and severe diarrheal illness in immunocompromised patients, particularly people living with HIV/AIDS. This infection contributes substantially to morbidity and mortality in patients with diminished immune function. The present study investigated the prevalence of C. parvum infection, its association with selected socio-demographic factors, and its relationship with CD4 cell counts among HIV/AIDS patients presenting with diarrhea at the Jos University Teaching Hospital (JUTH), Nigeria. A hospital-based cross-sectional study was conducted among 200 HIV-positive patients presenting with diarrhea. Stool samples were collected and examined for C. parvum oocysts using the modified Ziehl-Neelsen staining technique, while CD4 counts were retrieved
from patient medical records. Socio-demographic and clinical information were gathered through structured questionnaires. Statistical analyses were performed to evaluate associations between C. parvum infection, socio-demographic variables, and CD4 counts. Of the 200 samples examined, 22 (11.0%) tested positive for C. parvum. Males accounted for 15 (68.0%) positive cases and females for 7 (32.0%), yielding a male-to-female ratio of 2:1. The highest proportion of positive cases (19 cases, 86.4%) occurred among patients with CD4 counts below 200 cells/μL. The source of drinking water was a significant determinant, with 81.8% of infected participants consuming untreated water. No statistically significant association was observed between infection and age, place of residence, marital status, frequency of eating outside, or frequency of diarrhea. Microsporidium was also detected with a prevalence of 4.0%, and a co-infection prevalence with C. parvum of 3.0%. These findings underscore that C. parvum remains a clinically relevant opportunistic pathogen among HIV/AIDS patients with
diarrhea in Jos, driven largely by immunosuppression and inadequate water treatment. Routine screening for intestinal parasites, improved sanitation, safe water access, and health education are essential strategies to reduce the burden of cryptosporidiosis in this vulnerable population.