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B3.3 Intestinal parasitic infections in AIDS patients at the okomfo anokye teaching hospital, Kumasi-Ghana
Free Papers~International Journal of Antimicrobial Agents 26S (2005) $65 Sl12 antibody positive HIV-1 infected patients in our patient population. The HCV genotypes l a and lb were the most prevalent in our study patients. We did not find any statistical significance between the HCV viral load and liver enzymes.
B3.3
$87
B4. M a l a r i a B4.1 Clinical Etlieaey of ChloroquineJPrimaquine Against Plasmodium rirax Infections in Hospitalized Children from Sucre, Venezuela
Intestinal Parasitic Infections in AIDS Patients at the Okomfo Anokye Teaching Haspital, Kumasi-Ghana
Alfonso J. RODRIGUEZ-MORALES, Elia SANCHEZ, Miguel VARGAS, Carmelina PICCOLO, Rosa COLINA, Melissa ARRIA, Jesus A. BENITEZ. Universidad de Los Andes, Trujillo,
Samuel Crowther TAY, Yaw A g y k u m BOAITEY. Universi~ of Seiet~'e
Venezuela; Hospital Santos Anibal Dominicci, Car@ano, Sucre, Venezuela; DGSACS-MSDS, Maracay, Venezuela
and Technolo~, School of Medical Sciences, Kumasi, Ghana
Objectives: To survey the types and severity of intestinal parasitic infection in HIV/AIDS patients in Ghana and to compare level of parasitic infection by gender and age Significance: Most HIV/AIDS patients die from opportunistic infection. Whereas HIV infection may alter tile natural history of parasitic disease, impede rapid diagnosis or reduce tile efficiency of anti-parasitic treatment, parasitosis may facilitate the infection with HIV as well as the progression from asymptomatic infection to AIDS. Knowledge of the epidemiology of these infections is central to their treatment, control and prevention. Study Design: Cross-sectional study Setting: Hospital Population: HIV/AIDS patients Methodology: Routine stool examinations were done on the HIV/AIDS patients. Results: A total of 100 HIV/AIDS patients (46 males and 54 females) were included. Of these 100 patients, 39 were positive for parasites (119 males and 20 females) with tile following parasites identified: Cryptosporkiium (CP) in 26/39 (66.7%1), Giardia lamblia (GL) in 6/39 (115.4%1), Strongyloides stereoralis (SS) in 3/39 (17.7%1), and both Schistosoma mansoni (SM) and hookworms (HW) in 2/39 (5.1%1). Table 1 Distribution of Positive Cases According to Gender and Type of Parasite SM
GL
SS
HW
CP
Total
% of Total
1 1 2
4 2 6
2 1 3
1 1 2
11 15 26
19 20 39
48.7 51.3 100.0
Male Female TOTAL
Table 2 Distribution of Specific Parasitic Infection by Age Group AGE 11 20 21 30 31 40 41 50 51-60 TOTAL
SM
%
GL
%
SS
%
HW
%
CP
%
0 2 0 0 0 2
0.0 100.0 0.0 0.0 0.0 100.0
0 2 1 3 0 6
0.0 33.3 16.7 50.0 0.0 100.0
0 2 0 1 0 3
0.0 66.7 0.0 33.3 0.0 100.0
0 1 1 0 0 2
0.0 50.0 50.0 0.0 0.0 100.0
0 7 17 2 0 26
0.0 26.9 65.4 7.7 0.0 100.0
Conclusions: Age and gender do not determine the rate of parasitic infection in AIDS patients. None of the drugs currently available for the treatment of HIV/AIDS patients can eradicate tile infection. As such, tile findings of this study are very important, because these parasites can be eliminated using cheap drugs except in tile case of Cryptosporidium. The findings of this project will be used to help in the treatment of HIV/AIDS patients with suspected intestinal parasitic infection since a parasitic disease may cause severe pathological effects and even death. Health education and wm'kshop will be organized for HIV/AIDS patients on tile transmission, prevention and control of intestinal parasites. Drinking of bottled water instead of regular water to prevent infection of water born intestinal parasites is recommended.
Objective: To evaluate the clinical efficacy of antimalarial drug acfiemes used in a malaria endemic area in northeastern Venezuela, with use of chloroquine and primaquine, in children infected with Plasmodium vivax
Significance: Emergence of P. vivax resistance strains in some parts of the world imposes the need to conduct surveillance of the clinical efficacy and/or susceptibility of P. vivax to antimalarial drugs. Study Design: Prospective cohort Setting: An urban hospital/main clinical referral center close to tile malaria endemic area in nortfieaatern Venezuela Population: Venezuelan children with Plasmodium vivax malaria Methodology: Children with P vivax monoinfections (by thick and thin blood smears) requiring hospitalization were treated with chloroquine and primaquine, and followed up over a period of two years. All patients received ctdoroquine (10mg/kg on days 1 and 2, then 5mg/kg on day 3 for a total of 25mg/kg). Piimaquine was given to all ckildien > 1 month of age at 0.25mg/kg/day for 14 days for a total of 3.5 mg/kg. All ckildren were clinically evaluated for treatment efficacy by general practitioners as well as by pediatricians and an infectious disease specialist. Results: Seventy eight children with a mean age of 4 years ( ± 3 . 5 years) were included. Of these, 62.8% were younger than 5 years; 51.3% were female and 47.4% male. Clinical features included: 93.59% with fevei, 41.03% with chills and 14.10% with headache, among others; 63% presented 2-3 clinical manifestations. Co-morbidity was noted in 83.33% with the anemic syndrome in 94.87% (p<0.01), malnutrition in 25.64%, intestinal parasitism in 10.26%. Baseline Hb was 8.09 ± 2.65 g/dL. Baseline platelet count was 127402 ± 143 132 per m m 3. Thi'ombocytopenia was noted in 58.97%. Transfusions were necessary in 25.64% of tile patients. No complications were seen in these patients. All tolerated tile treatment well. After a mean of 7.27 ± 4.56 days of hospitalization, patients were discharged clinically improved, with negative thin and thick smears and a mean Hb at outcome: 9.54 ± 1.95 g/dL (p<0.01) and platelets at outcome: 214 583 ± 147 372 per m m 3 (p<0.01). No further complications were seen. Conclusiml: According to our results and others in tile countly, chloroquine and primaquine remain as drugs of choice in tile treatment of R vivax malaria, given as we used in this study as per national antimalarial policy. Further studies of surveillance are necessary, probably to include in the future in vitro techniques to evaluate R vivax susceptibility to antimalarial drugs.
B6. T u b e r c u l o s i s B6.1 Incidenee of Hepatotoxicity due to Antitubereulosis Medication and Assessment of Risk Factors, Zahedan, Iran Batool SHARIFI MOOD, Hamid Reza KOUHPAYEH, Masoud SALEHI.
Boo-all Hospital, Zahedan, tran Objectives: To determine the incidence of and risk factors for antitu berculosis drug induced hepatotoxieity among tuberculous patients in an endemic area, Zafiedan, Irma
B3.3
$87
B4. M a l a r i a B4.1 Clinical Etlieaey of ChloroquineJPrimaquine Against Plasmodium rirax Infections in Hospitalized Children from Sucre, Venezuela
Intestinal Parasitic Infections in AIDS Patients at the Okomfo Anokye Teaching Haspital, Kumasi-Ghana
Alfonso J. RODRIGUEZ-MORALES, Elia SANCHEZ, Miguel VARGAS, Carmelina PICCOLO, Rosa COLINA, Melissa ARRIA, Jesus A. BENITEZ. Universidad de Los Andes, Trujillo,
Samuel Crowther TAY, Yaw A g y k u m BOAITEY. Universi~ of Seiet~'e
Venezuela; Hospital Santos Anibal Dominicci, Car@ano, Sucre, Venezuela; DGSACS-MSDS, Maracay, Venezuela
and Technolo~, School of Medical Sciences, Kumasi, Ghana
Objectives: To survey the types and severity of intestinal parasitic infection in HIV/AIDS patients in Ghana and to compare level of parasitic infection by gender and age Significance: Most HIV/AIDS patients die from opportunistic infection. Whereas HIV infection may alter tile natural history of parasitic disease, impede rapid diagnosis or reduce tile efficiency of anti-parasitic treatment, parasitosis may facilitate the infection with HIV as well as the progression from asymptomatic infection to AIDS. Knowledge of the epidemiology of these infections is central to their treatment, control and prevention. Study Design: Cross-sectional study Setting: Hospital Population: HIV/AIDS patients Methodology: Routine stool examinations were done on the HIV/AIDS patients. Results: A total of 100 HIV/AIDS patients (46 males and 54 females) were included. Of these 100 patients, 39 were positive for parasites (119 males and 20 females) with tile following parasites identified: Cryptosporkiium (CP) in 26/39 (66.7%1), Giardia lamblia (GL) in 6/39 (115.4%1), Strongyloides stereoralis (SS) in 3/39 (17.7%1), and both Schistosoma mansoni (SM) and hookworms (HW) in 2/39 (5.1%1). Table 1 Distribution of Positive Cases According to Gender and Type of Parasite SM
GL
SS
HW
CP
Total
% of Total
1 1 2
4 2 6
2 1 3
1 1 2
11 15 26
19 20 39
48.7 51.3 100.0
Male Female TOTAL
Table 2 Distribution of Specific Parasitic Infection by Age Group AGE 11 20 21 30 31 40 41 50 51-60 TOTAL
SM
%
GL
%
SS
%
HW
%
CP
%
0 2 0 0 0 2
0.0 100.0 0.0 0.0 0.0 100.0
0 2 1 3 0 6
0.0 33.3 16.7 50.0 0.0 100.0
0 2 0 1 0 3
0.0 66.7 0.0 33.3 0.0 100.0
0 1 1 0 0 2
0.0 50.0 50.0 0.0 0.0 100.0
0 7 17 2 0 26
0.0 26.9 65.4 7.7 0.0 100.0
Conclusions: Age and gender do not determine the rate of parasitic infection in AIDS patients. None of the drugs currently available for the treatment of HIV/AIDS patients can eradicate tile infection. As such, tile findings of this study are very important, because these parasites can be eliminated using cheap drugs except in tile case of Cryptosporidium. The findings of this project will be used to help in the treatment of HIV/AIDS patients with suspected intestinal parasitic infection since a parasitic disease may cause severe pathological effects and even death. Health education and wm'kshop will be organized for HIV/AIDS patients on tile transmission, prevention and control of intestinal parasites. Drinking of bottled water instead of regular water to prevent infection of water born intestinal parasites is recommended.
Objective: To evaluate the clinical efficacy of antimalarial drug acfiemes used in a malaria endemic area in northeastern Venezuela, with use of chloroquine and primaquine, in children infected with Plasmodium vivax
Significance: Emergence of P. vivax resistance strains in some parts of the world imposes the need to conduct surveillance of the clinical efficacy and/or susceptibility of P. vivax to antimalarial drugs. Study Design: Prospective cohort Setting: An urban hospital/main clinical referral center close to tile malaria endemic area in nortfieaatern Venezuela Population: Venezuelan children with Plasmodium vivax malaria Methodology: Children with P vivax monoinfections (by thick and thin blood smears) requiring hospitalization were treated with chloroquine and primaquine, and followed up over a period of two years. All patients received ctdoroquine (10mg/kg on days 1 and 2, then 5mg/kg on day 3 for a total of 25mg/kg). Piimaquine was given to all ckildien > 1 month of age at 0.25mg/kg/day for 14 days for a total of 3.5 mg/kg. All ckildren were clinically evaluated for treatment efficacy by general practitioners as well as by pediatricians and an infectious disease specialist. Results: Seventy eight children with a mean age of 4 years ( ± 3 . 5 years) were included. Of these, 62.8% were younger than 5 years; 51.3% were female and 47.4% male. Clinical features included: 93.59% with fevei, 41.03% with chills and 14.10% with headache, among others; 63% presented 2-3 clinical manifestations. Co-morbidity was noted in 83.33% with the anemic syndrome in 94.87% (p<0.01), malnutrition in 25.64%, intestinal parasitism in 10.26%. Baseline Hb was 8.09 ± 2.65 g/dL. Baseline platelet count was 127402 ± 143 132 per m m 3. Thi'ombocytopenia was noted in 58.97%. Transfusions were necessary in 25.64% of tile patients. No complications were seen in these patients. All tolerated tile treatment well. After a mean of 7.27 ± 4.56 days of hospitalization, patients were discharged clinically improved, with negative thin and thick smears and a mean Hb at outcome: 9.54 ± 1.95 g/dL (p<0.01) and platelets at outcome: 214 583 ± 147 372 per m m 3 (p<0.01). No further complications were seen. Conclusiml: According to our results and others in tile countly, chloroquine and primaquine remain as drugs of choice in tile treatment of R vivax malaria, given as we used in this study as per national antimalarial policy. Further studies of surveillance are necessary, probably to include in the future in vitro techniques to evaluate R vivax susceptibility to antimalarial drugs.
B6. T u b e r c u l o s i s B6.1 Incidenee of Hepatotoxicity due to Antitubereulosis Medication and Assessment of Risk Factors, Zahedan, Iran Batool SHARIFI MOOD, Hamid Reza KOUHPAYEH, Masoud SALEHI.
Boo-all Hospital, Zahedan, tran Objectives: To determine the incidence of and risk factors for antitu berculosis drug induced hepatotoxieity among tuberculous patients in an endemic area, Zafiedan, Irma