Intestinal Parasites Associated with Opportunistic Coccidial Infections Among Immunocompromised Individuals in Central Iran: A Cross Sectional Study

Abstract

Background: Protozoa and helminthic parasites are the most common opportunistic parasites infections associated with the gastrointestinal tract in immunocompromised patients. Objectives: There have been very few studies addressing this issue in central Iran and our purpose was to determine the frequency of the intestinal parasitic infections (IPIs) in different groups of immunocompromised patients admitted to the referral hospitals in Isfahan, Iran. Methods: A cross-sectional study was performed on 204 immunocompromised patients (HIV/AIDS, lymphoma, leukemia, renal transplant and other transplants) between 2015 - 2016. Stool samples were analyzed for intestinal parasites using direct-smear, formol-ether concentration method and modified Ziehl-Neelsen staining techniques. Results: The total rate of any parasites was 43.1 (88/204) in the patients. The prevalence of parasites was 32.7 (17/52), 39.6 (19/48), 46.2 (18/39), 56.0 (28/50), and 40.0 (6/15) in HIV/AIDS, lymphoma, leukemia, renal transplant recipients, and the other transplant recipients, respectively. Blastocystis hominis (30.4), Cryptosporidium spp. (3.9), Entamoeba coli (6.3), Giardia lamblia cyst (5.4), Endolimax nana (2), ova of Fasciola spp. (0.5) and Dicrocoelium dendriticum ( 0.9) were the overall parasites that were found in this study. The most common parasites which were related to diarrhea were Blastocystis hominis and Cryptosporidium spp. The parasitic infection was significantly higher in urban patients and females (P < 0.05). Nevertheless, no significant relationship was observed between the prevalence of parasitic infections and age, occupation and level of education. Conclusions: Our findings highlighted that IPIs are a common health problem among immunocompromised patients, in central Iran. Therefore these patients should be screened routinely for intestinal parasites and treated promptly.