An analysis of enteric pathogens among HIV infected individuals with and without diarrhea at Queen Elizabeth Central Hospital
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Date
2022-08-17
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Kamuzu University of Health Sciences
Abstract
Eastern and Southern Africa bears the blunt of the Human Immunodeficiency Virus (HIV) and
Acquired Immunodeficiency Virus Syndrome (AIDS) pandemic having about 54% of world’s
HIV/AIDS infected individuals coming from this region. Diarrhea is one of the most common
complications of HIV with 80% of all HIV/AIDS infected individuals developing this condition.
There is an association between CD4+ T cell count and presence of opportunistic infections.
Management of diarrhea in developing countries including Malawi depends on empirical
administration of drugs, mostly antibiotics. This is often times due to lack of proper diagnostic
capability to determine full profile of enteric pathogens that are likely to contribute to diarrhea for
particular patients.
Objective: To identify and determine entero-pathogens which are likely contributors of diarrhea
among HIV infected individuals in Malawi.
Specific Objectives:
Determine the profile of enteric pathogens across HIV infected individual with and without
diarrhea.
To identify pathogens detected in diarrheagenic amounts among HIV infected individuals
with and without diarrhea. To determine if the antibiotic prescribing pattern among clinicians covers enteropathogens
detected using TaqMan array card.
To determine if there is an association between CD4 T cell count and type of pathogens
detected in HIV positive individuals with and without diarrhea.
Methods: This study will be nested in a phase 2A clinical Trial investigating the safety and
efficacy of Clofazimine for treatment of Cryptosporidiosis among HIV+ adults. Two arms of study
participants will be used to answer our questions; 22 HIV infected individuals with diarrhea and
10 infected individuals without diarrhea. TaqMan array based polymerase chain reaction (PCR)
was used to detect multiple enteric pathogens from stool samples in the main study. In this study threshold cycle (Ct) values and pathogens detected from each group will be analyzed and used to
determine the mostly likely pathogen contributing or causing diarrhea. In addition CD4 T cell
values and profile of identified entero-pathogens will be analyzed to determine if level of an
individual’s immunity plays a role in profile of enteric pathogens among HIV infected individuals.
Furthermore, antibiotics that were administered to manage diarrhea will be analyzed to determine
whether it necessary for treating the type of pathogens detected.
Study Place: Data analysis and investigations will be conducted at the College of Medicine
Department of Pathology and college of medicine Library.
Expected outcome: We expect to identify enteric pathogens that are more likely than others to
contribute to diarrhea among HIV infected individuals. We will identify pathogens and make
profile of pathogens in relation to CD4 T cell values. This data will be essential for policy
formulation for management of diarrhea in HIV infected adults since treatment is mostly empirical
in developing countries such as Malawi due to poor diagnostic capacity.
Description
This is a retrospective case-control study