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Prevalence and correlates of helminth co-infection in Kenyan HIV-1 infected adults.

ABSTRACT: Deworming HIV-1 infected individuals may delay HIV-1 disease progression. It is important to determine the prevalence and correlates of HIV-1/helminth co-infection in helminth-endemic areas.HIV-1 infected individuals (CD4>250 cells/ul) were screened for helminth infection at ten sites in Kenya. Prevalence and correlates of helminth infection were determined. A subset of individuals with soil-transmitted helminth infection was re-evaluated 12 weeks following albendazole therapy.Of 1,541 HIV-1 seropositive individuals screened, 298 (19.3%) had detectable helminth infections. Among individuals with helminth infection, hookworm species were the most prevalent (56.3%), followed by Ascaris lumbricoides (17.1%), Trichuris trichiura (8.7%), Schistosoma mansoni (7.1%), and Strongyloides stercoralis (1.3%). Infection with multiple species occurred in 9.4% of infections. After CD4 count was controlled for, rural residence (RR 1.40, 95% CI: 1.08-1.81), having no education (RR 1.57, 95% CI: 1.07-2.30), and higher CD4 count (RR 1.36, 95% CI: 1.07-1.73) remained independently associated with risk of helminth infection. Twelve weeks following treatment with albendazole, 32% of helminth-infected individuals had detectable helminths on examination. Residence, education, and CD4 count were not associated with persistent helminth infection.Among HIV-1 seropositive adults with CD4 counts above 250 cells/mm(3) in Kenya, traditional risk factors for helminth infection, including rural residence and lack of education, were associated with co-infection, while lower CD4 counts were not.

SUBMITTER: Walson JL

PROVIDER: S-EPMC2846937 | biostudies-literature | 2010 Mar

REPOSITORIES: biostudies-literature

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Prevalence and correlates of helminth co-infection in Kenyan HIV-1 infected adults.

Walson Judd L JL Stewart Barclay T BT Sangaré Laura L Mbogo Loice W LW Otieno Phelgona A PA Piper Benjamin K S BK Richardson Barbra A BA John-Stewart Grace G

PLoS neglected tropical diseases 20100330 3

<h4>Background</h4>Deworming HIV-1 infected individuals may delay HIV-1 disease progression. It is important to determine the prevalence and correlates of HIV-1/helminth co-infection in helminth-endemic areas.<h4>Methods</h4>HIV-1 infected individuals (CD4>250 cells/ul) were screened for helminth infection at ten sites in Kenya. Prevalence and correlates of helminth infection were determined. A subset of individuals with soil-transmitted helminth infection was re-evaluated 12 weeks following alb ...[more]

PMID: 20361031

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Project description:BACKGROUND:The dynamics of helminth infection in African elephant populations are poorly known. We examined the effects of age, sex, social structure and the normalized difference vegetation index (NDVI) as primary drivers of infection patterns within and between elephant populations. METHODS:Coprological methods were used to identify helminths and determine infection patterns in distinct elephant populations in Maasai Mara National Reserve, Tsavo East National Park, Amboseli National Park and Laikipia-Samburu Ecosystem. Gaussian finite mixture cluster analyses of egg dimensions were used to classify helminth eggs according to genera. Generalized linear models (GLM) and Chi-square analyses were used to test for variation in helminth infection patterns and to identify drivers in elephant populations. RESULTS:Helminth prevalence varied significantly between the studied populations. Nematode prevalence (96.3%) was over twice as high as that of trematodes (39.1%) in elephants. Trematode prevalence but not nematode prevalence varied between populations. Although we found no associations between helminth infection and elephant social groups (male vs family groups), the median helminth egg output (eggs per gram, epg) did vary between social groups: family groups had significantly higher median epg than solitary males or males in bachelor groups. Young males in mixed sex family groups had lower epg than females when controlling for population and age; these differences, however, were not statistically significant. The average NDVI over a three-month period varied between study locations. Cluster analyses based on egg measurements revealed the presence of Protofasciola sp., Brumptia sp., Murshidia sp., Quilonia sp. and Mammomonogamus sp. GLM analyses showed that the mean epg was positively influenced by a three-month cumulative mean NDVI and by social group; female social groups had higher epg than male groups. GLM analyses also revealed that epg varied between elephant populations: Samburu-Laikipia elephants had a higher and Tsavo elephants a lower epg than Amboseli elephants. CONCLUSIONS:Elephants had infection patterns characterized by within- and between-population variation in prevalence and worm burden. Sociality and NDVI were the major drivers of epg but not of helminth prevalence. Gastrointestinal parasites can have a negative impact on the health of wild elephants, especially during resource scarcity. Thus, our results will be important when deciding intervention strategies.

Project description:INTRODUCTION:Global efforts to end HIV by 2030 focus on reducing and eventually eliminating new infections in priority populations. Identifying these populations and characterizing their vulnerability factors helps in guiding investment of scarce HIV prevention resources to achieve maximum impact. We sought to establish HIV prevalence, spatial distribution and risk factors for HIV infection in the Kenyan fishing communities of Lake Victoria. METHODS:We conducted a cross-sectional survey of 2637 people from all the 308 fish-landing beaches on the Kenyan shore of Lake Victoria. The number of participants enrolled at each beach were weighted based on the size of the beach, determined by the number of functional registered boats. We used simple random sampling to select those to be approached for study participation. Consenting participants were privately interviewed about their socio-economic and demographic characteristics and sexual behavior, and were invited for HIV test using the Kenya rapid HIV testing protocol. We used descriptive statistics and multivariate logistic and linear regression for analysis. RESULTS:We found high HIV prevalence of 32% with significant differences between men (29%) and women (38%). Among men, having an HIV negative sexual partner, being circumcised, increasing number of condom protected sex acts in the preceding month, being younger and being a resident of Homa Bay, Kisumu, Siaya and Busia counties compared to Migori County reduced the risk of HIV infection. For women, being married, having more children with the current spouse, having an HIV negative sexual partner and being a resident of Busia compared to Migori County reduced the risk of HIV infection. We also found that longer distance from the beaches to the nearest public health facilities was associated with increasing cumulative HIV prevalence at the beaches. CONCLUSION:Fishing communities have high HIV prevalence and may greatly benefit from interventions such as wider ART coverage, couple HIV risk reduction counseling, PrEP use for HIV negative partner at substantial continuous risk, alongside other HIV prevention services that the Kenyan government is currently rolling out. This will additionally require adequate plans to synchronize the provision of these services with the population's routine schedules for all these options to be reasonably accessible to them.

Dataset Information

Prevalence and correlates of helminth co-infection in Kenyan HIV-1 infected adults.

Publications

Prevalence and correlates of helminth co-infection in Kenyan HIV-1 infected adults.

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