Frederick Olusegun Akinbo

Molecular Epidemiologic Characterization of Enterocytozoon bieneusi in HIV-Infected Persons in Benin City, Nigeria

Molecular characterization of Enterocytozoon bieneusi has led to better understanding of microsporidiosis transmission in humans. This study aimed to detect and genotype E. bieneusi in human immunodeficiency virus (HIV)-infected persons. Stool specimens were collected from 463 HIV-infected patients and analyzed for E. bieneusi by polymerase chain reaction (PCR) and DNA sequence analysis of the internal transcribed spacer. E. bieneusi was detected in 77 HIV patients. CD4 cell counts < 200 cells/μL was associated with E. bieneusi infection (P = 0.09). E. bieneusi was significantly associated with weight loss (P < 0.0001), diarrhea (P = 0.006), fever (P < 0.0001), not being married (P < 0.0001), and flush type of toilet (P = 0.0007). Six known genotypes of D, A, IV, CAF2, EbpA, and Peru 8 in 31, 22, 14, 2, 1, and 1 patients, respectively, five novel genotypes of E. bieneusi, and one infection with mixed genotypes were observed in this study. Three of the novel genotypes were genetically distant to the genotypes commonly found in humans.

Prevalence of intestinal parasitic infections among HIV patients in Benin City, Nigeria.

This study was carried out to determine the presence of intestinal parasites and their correlation with CD4+ T-cell counts and demographics among human immunodeficiency virus (HIV)-positive patients in Benin City, Nigeria. Stool specimens from 2,000 HIV-positive patients and 500 controls (HIV-negative individuals) were examined for ova, cysts, or parasites, using standard procedures. In addition, patients blood samples were analyzed for CD4 counts by flow cytometry. An overall prevalence rate of 15.3% was observed among HIV-positive patients while 6.2% was noted among non-HIV subjects. HIV status was a significant (P<0.0001) risk factor for acquiring intestinal parasitic infections. Male gender, CD4 count <200cell/µl, and diarrhea were significantly associated with an increased prevalence of intestinal parasitic infections among HIV-positive patients. The level of education, occupation, and source of water among HIV patients significantly (P<0.0001) affected the prevalence of intestinal parasitic infections. Ascaris lumbricoides was the most predominant parasite in both HIV-positive patients and controls. A CD4 count <200 cells/µl was significantly associated with only Isospora belli and Cryptosporidium infections. The presence of pathogenic intestinal parasites such as A. lumbricoides, hookworm, Giardia intestinalis, Entamoeba histolytica, Trichuris trichiura, and Taenia species among HIV-infected persons should not be neglected. Cryptosporidium species and I. belli were the opportunistic parasites observed in this study. Routine screening for intestinal parasites in HIV-positive patients is advocated.

Multilocus sequence typing of Enterocytozoon bieneusi: Lack of geographic segregation and existence of genetically isolated sub-populations☆

The population structure of Enterocytozoon bieneusi was examined by multilocus sequence typing (MLST) of 64 specimens from AIDS patients in Peru, Nigeria, and India and five specimens from captive baboons in Kenya using a combination of the ribosomal internal transcribed spacer (ITS) and four microsatellite and minisatellite markers. Parasites in different geographic locations (Peru, India, and Nigeria) all had strong and significant linkage disequilibrium (LD) and only limited recombination, indicative of a clonal population structure in E. bieneusi from each location. When isolates of various geographical areas were treated as a single population, phylogenetic analysis and substructural analysis using STRUCTURE found no evidence for the existence of geographically segregated sub-populations. Nevertheless, both analyses revealed the presence of two major genetically isolated groups of E. bieneusi: one (sub-population 1) contained all isolates of the anthroponotic ITS genotype A, whereas the other (sub-population 2) harbored isolates of multiple ITS genotypes with zoonotic potential. This was also supported by FST analysis. The measurement of LD and recombination rates indicated that sub-population 2 had a clonal population structure, whereas sub-population 1 had an epidemic population structure. The data confirmed the existence of genetic sub-populations in E. bieneusi that may be transmitted differently in humans.

Unusual Enterocytozoon bieneusi Genotypes and Cryptosporidium hominis Subtypes in HIV-Infected Patients on Highly Active Antiretroviral Therapy

Human immunodeficiency virus (HIV)-infected persons are commonly infected with Cryptosporidium species and Enterocytozoon bieneusi in both developed and developing countries, particularly patients with CD4+ cell counts below 200 cells/μL; 285 HIV-infected patients on highly active antiretroviral therapy (HAART) were enrolled in this study, and both stool and blood specimens were collected from participants. The stool specimens were analyzed and typed for E. bieneusi and Cryptosporidium spp. by polymerase chain reaction (PCR) and DNA sequencing. CD4 count was analyzed using flow cytometry. E. bieneusi and Cryptosporidium were detected in 18 (6.3%) and 4 (1.4%) patients, respectively. The E. bieneusi detected mostly belonged to a new genotype group that, thus far, has only been found in a few humans: genotype Nig4 in 2 patients and two new genotypes related to Nig4 in 12 patients. The Cryptosporidium detected included C. hominis (two patients), C. parvum (one patient), and C. felis (one patient), with the two C. hominis infections belonging to an unusual subtype family. Additional studies are required to determine whether some E. bieneusi genotypes and C. hominis subtypes are more prevalent in HIV patients on HAART.

Molecular Characterization of Cryptosporidium spp. in HIV-infected Persons in Benin City, Edo State, Nigeria

The use of molecular tools in epidemiological investigations has provided new insights into the transmission of cryptosporidiosis in humans and animals. This study aimed to characterize the transmission of cryptosporidiosis in human immunodeficiency virus (HIV)-infected patients. Stool specimens were collected from 500 HIV-infected patients as part of the routine patient care. Cryptosporidium species in stool specimens were detected and differentiated using a small subunit rRNA-based polymerase chain reaction-restriction fragment length polymorphism technique. C. hominis and C. parvum were found and subtyped by DNA sequence analysis of the 60 kDa glycoprotein (gp60) gene. Cryptosporidium species were detected in 36 HIV patients and none were found among non-HIV patients. A CD4+ count

Prevalence of intestinal parasites among patients of a tertiary hospital in Benin city, Nigeria

Background: Intestinal parasitic infections have been described as constituting the greatest single worldwide cause of illness and disease. Aim: The objective of this study is to investigate the prevalence of intestinal parasitic infections in relation to sex and age as well as seasons of the year in Benin city, Nigeria. Materials and Methods: The stool samples were processed using saline and iodine mounts and examined microscopically for ova and cysts of parasites. Results: The overall prevalence of intestinal parasitic infections was 3.9% while gender and season had no correlation with the prevalence of intestinal parasites (P = 0.548, P = 0.696). There was a significant relationship between intestinal parasitic infection and age (P < 0.033). Ascaris lumbricoides was the most prevalent (51.4%) while Entamoeba histolytica had the least prevalence (5.4%). Conclusion: The results of this study concluded that 36 patients were infected with various intestinal parasites and that age significantly affected the prevalence of parasitic infections. Effective treatment of infected patients and improved sanitary habits is advocated.

Prevalence of Malaria and Anemia Among Young Children in a Tertiary Hospital in Benin City, Edo State, Nigeria

We aimed to determine the prevalence of malaria and anemia among children ≤ 5 years old in Benin City, Edo State, Nigeria. We also assessed the effects of age and sex on disease prevalence. Blood samples were collected from 1325 children (744 males and 581 females) with signs and symptoms of malaria. Malaria parasitemia was diagnosed by microscopy, while anemia was defined as hemoglobin concentration p p p = 0.006) higher prevalence. Generally and among males, age affected the prevalence of anemia with children 4–5 years old having significantly ( p p

Intestinal parasitic infections among artisans in Benin city, Nigeria

Context: Human intestinal parasites have always been a major health problem in the developing countries. This study was aimed at determining the prevalence of intestinal parasitic infections among artisans and establishes a relationship between the prevalence of intestinal parasitic infections and risk-factors. Materials and Methods: A total of 353 participants which consisted of 272 males and 81 females were recruited for this study with age ranging from 18 to 65 years. Stool specimens were collected from the participants and analysed using the standard technique. The data obtained were analysed using Chi-square (χ2 ) to compare the frequency data while the odd ratio was calculated for potential risk factors. Results: Out of 353 subjects, 118 (33.4%) subjects had intestinal parasitic infections. Age, gender, marital status, occupation, educational status and source of food did not significantly affect (P = 0.219, P = 0.920, P = 0.276, P = 0.087, P = 0.074 and P = 0.442, respectively) the prevalence of intestinal parasitic infections. The use of well/rain water (odds ratio [OR] =2.721; 95% confidence interval [CI] = 1.452, 5.100; P = 0.002) and presence of diarrhoea (OR = 6.169; 95% CI = 3.665, 10.474; P < 0.0001) were significantly associated with intestinal parasitic infections among artisans. Defecating in nearby bushes resulted in a significantly increased prevalence of intestinal parasitic infections among artisans (P < 0.0001). The intestinal parasites recovered were Ascaris lumbricoides, hookworm, Trichuris trichiura and Entamoeba histolytica. A. lumbricoides had the highest prevalence (77.8%). The male gender had the highest prevalence in all the four intestinal parasites recovered in this study. Conclusion: Overall prevalence of 34.4% of intestinal parasitic infections was observed among artisans in Benin City. The source of water, type of toilet and presence of diarrhoea significantly affected the prevalence of intestinal parasitic infections among artisans. A. lumbricoides was the most prevalent parasitic agent recovered in this study.

Prevalence of trichomoniasis among pregnant women in Benin City

Background: Trichomonas vaginalis has been recognized as a cosmopolitan parasite of male and female genital tract. This study was conducted to determine the prevalence of asymptomatic trichomoniasis among pregnant women in Benin City, Edo State. Materials and Methods: A total of 300 patients and subjects consisting of 250 pregnant women attending antenatal clinics and 50 non-pregnant apparently healthy subjects who served as controls were recruited in this study. The age ranged from 20 to 40 years. High vaginal swab was collected from each participant and T. vaginalis was diagnosed by microscopy. Results: An overall prevalence of 2.8% of trichomoniasis was observed among pregnant women. Gestational age and educational status of pregnant women were significantly associated with the prevalence of trichomoniasis. Conclusion: Asymptomatic T. vaginalis infection is common in pregnancy. We recommend routine screening for this infection in order to reduce the potential adverse pregnancy outcomes.

Intestinal parasitic infections among spare parts traders in Benin city, Nigeria

Background: The accumulation of metals in the human system may inhibit or enhance the growth of pathogens, particularly parasitic infections. Objective: This study was conducted to determine the prevalence of intestinal parasitic infections among spare parts traders in Benin City, Edo State, Nigeria. Materials and Methods: Two hundred and two male traders were recruited for this study. The age of participants ranged from 20 to 67 years. Freshly voided stool specimen was obtained from each participant into clean wide-mouthed universal container. Intestinal parasites were diagnosed using microscopy. Results: An overall prevalence of 22.8% of intestinal parasitic infections was observed in this study. Age, marital status, and source of food significantly increased the risk of intestinal parasitic infections among spare parts traders. Ascaris lumbricoides, Strongyloides stercoralis, hookworm, Entamoeba histolytica, and Fasciola hepatica were the parasites observed in this study. In all age groups and those who eat from food vendors, A. lumbricoides was the most recovered parasite among spare parts traders. Conclusion: Further studies to elucidate the role of immunotoxic metals in intestinal parasitic infections, inclusion of economically productive age groups in the treatment plan, and improvement of personal hygiene are advocated.