Prevalence of enteropathogens in children with persistent diarrhoea and malnutrition with or without HIV infection before and after nutritional intervention at UTH

Abstract

Persistent diarrhoea leads to malnutrition and the malnutrition that develops predisposes to further persistent diarrhoea. This becomes a persistent diarrhoea-malnutrition - persistent diarrhoea vicious cycle which is a complex of infection and host immune dysfunction that involve protein,calorie and micronutrient deficiency.The most common intestinal infection on admission were Cryptosporidium parvum (26%),salmonella spp (18%) and Giardia Intestinalis {6%), the prevalence of which was not influenced by type of malnutrition or the HIV serostatus. The HIV serostatus was found to be 54% in these children under study aged 6 - 2 4 months. At the end of the study, the same enteropathogens remained dominant with Cryptosporidium(13%), Salmonella spp (30.7%) and Giardia Intestinalis (7.8%)) the commonest. HIV serostatus and absence of diarrhoea didn't influence their prevalence. Pathogens appear to have been tolerated as commensals after nutritional rehabilitation. 78% of marasmic children were HIV seropositive as compared to 37% in those with kwashiorkor.Of the 39 children who died, 35 were tested for presence of HIV antibodies, 25 of which were found to be HIV seropositive and 10 HIV seronegative. Cryptosporidium, marasmic-kwashiorkor, marasmus and HIV-seropositivity were associated with high mortality.