Abstract

Hafiz Yahya Mohammed*, Abdalmoneim M. Magboul, Mohammed A. Suliman, Hanan B. Eltahir and Ibrahim M. Hassan

ABSTRACT

Severe life-threatening diarrheal disease is a common complication of infection with HIV. Cryptosporidium has gained importance as an AIDS indicator disease and a cause of intractable diarrhoea in immunosuppressed individuals. With the increasing number of individuals with HIV, cancer patients and malnourished children suffering from diarrheal illness, need for the easy, cheap and quick method for diagnosis is required to reduce the morbidity. There for, this study was conducted to detect Cryptosporidium oocysts in the stool samples of HIVinfected patients using Kinyoun Cold Acid Fast (KCAF) staining in concentrated stool and to compare these results with that obtained by ELISA technique. Stool specimens were collected from HIV positive patients with (n= 90) and without (n=90) diarrhea along with their HIV negative counterparts (n=200) and examined using Kinyoun Cold Acid Fast (KCAF) staining method to identify Cryptosporidium oocysts. ELISA using Cryptosporidium microplate assays for detection of Cryptosporidium antigen was also conducted on all stool specimens. The overall prevalence of Cryptosporidium was found to be 42/380 (11.1%) and 57/380 (15%) by KCAF staining and ELISA respectively. Detection of Cryptosporidium in HIV positive subjects with diarrhea by KCAF staining was 18 (20%) and by ELISA the detection rate went up to 28 (31.1%). All detailed results were statistically compared taking KCAF staining as gold standard which revealed ELISA method to have sensitivity of 83.88% and specificity of 96.55%. Microscopic examinations for ova, cysts and larvae of other parasites were also done using saline and Lugol's iodine preparations. Keeping in mind the present scenario of HIV infection in Sudan and more so in Khartoum and Kosti, it is recommended to include detection of Cryptosporidium oocysts in routine parasitological examination of stool specimens.