The prison management in Malaysia is proactively seeking to
improve the health status of the prison inmates. Intestinal parasitic
infections (IPIs) are widely distributed throughout the world and are still
gaining great concern due to their significant morbidity and mortality among
infected humans. In Malaysia, there is a paucity of information on IPIs among
prison inmates. In order to further enhance the current health strategies
employed, the present study aims to establish firm data on the prevalence and
diversity of IPIs among HIV-infected and non-HIV-infected individuals in a
prison, an area in which informed knowledge is still very limited.
Samples were subjected to microscopy examination and
serological test (only for Strongyloides). Speciation for parasites on
microscopy-positive samples and seropositive samples forStrongyloides were
further determined via polymerase chain reaction. SPSS was used for statistical
analysis.
A total of 294 stool and blood samples each were
successfully collected, involving 131 HIV positive and 163 HIV negative adult
male inmates whose age ranged from 21 to 69-years-old. Overall
prevalence showed 26.5 % was positive for various IPIs. The IPIs detected
included Blastocystissp., Strongyloides stercoralis, Entamoeba spp., Cryptosporidium spp., Giardia spp., and Trichuris trichiura. Comparatively, the rate of IPIs
was slightly higher among the HIV positive inmates (27.5 %) than HIV
negative inmates (25.8 %). Interestingly, seropositivity for S. stercoralis was more predominant in HIV negative inmates
(10.4 %) compared to HIV-infected inmates (6.9 %), however these
findings were not statistically significant. Polymerase chain reaction (PCR)
confirmed the presence of Blastocystis, Strongyloides, Entamoeba histolytica and E. dispar.
These data will enable the health care providers and prison
management staff to understand the trend and epidemiological situations in
HIV/parasitic co-infections in a prison. This information will further assist
in providing evidence-based guidance to improve prevention, control and
management strategies of IPIs co-infections among both HIV positive and HIV
negative inmates in a prison environment.
Table 4 | |||||||||
| Risk factors of intestinal parasitic infections among participating prison inmates according to HIV status (n = 294) | |||||||||
| Characteristics | Overall (n = 294) | HIV positive (n = 131) | HIV negative (n = 163) | ||||||
| No. infected (%) | OR (95 % CI) | p | No. infected (%) | OR a (95 % CI) | p | No. infected (%) | OR (95 % CI) | p | |
| Age group (years) | |||||||||
| ≥40 | 31 (27.7) | 1.10 (0.65-1.87) | 0.727 | 16 (27.1) | 0.97 (0.45-2.09) | 0.933 | 15 (28.3) | 1.21 (0.58-2.54) | 0.607 |
| <40 | 47 (25.8) | 1 | 20 (27.8) | 1 b | 27 (24.5) | 1 | |||
| Education attainment | |||||||||
| Primary school and below | 20 (24.4) | 0.86 (0.48-1.54) | 0.605 | 7 (20.0) | 0.58 (0.23-1.47) | 0.247 | 13 (27.7) | 1.15 (0.53-2.47) | 0.725 |
| Secondary school and below | 58 (27.4) | 1 | 29 (30.2) | 1 | 29 (25.0) | 1 | |||
| Tuberculosis | |||||||||
| Yes | 8 (42.1) | 2.13 (0.82-5.51) | 0.112 | 8 (44.4) | 2.43 (0.87-6.76) | 0.094e | 0 | NA f | 0.535e |
| No | 70 (25.5) | 1 | 28 (24.8) | 1 | 42 (25.9) | ||||
| Hepatitis B or C | |||||||||
| Yes | 4 (18.2) | 0.60 (0.20-1.82) | 0.356 | 2 (11.1) | 0.29 (0.06-1.33) | 0.153e | 2 (50.0) | 2.98 (0.41-21.82) | 0.274e |
| No | 74 (27.2) | 1 | 34 (30.1) | 1 | 40 (25.2) | 1 | |||
| CD4 count c (cells/mm3 ) | |||||||||
| ≤200 | 8 (33.3) | 1.32 (0.48-3.58) | 0.590 | ||||||
| >200 | 19 (27.5) | 1 | |||||||
| Duration of having HIV (years) | |||||||||
| ≤10 | 26 (29.9) | 1.43 (0.63-3.36) | 0.386 | ||||||
| >10 | 10 (22.7) | 1 | |||||||
| HAART d | |||||||||
| No | 32 (26.9) | 0.74 (0.21-2.61) | 0.736e | ||||||
| Yes | 4 (33.3) | 1 | |||||||
Full article
at:
By:
1Department of Parasitology, Faculty of
Medicine, University of Malaya, Kuala Lumpur, Malaysia
2Penjara Utama Kajang, Kajang, Selangor,
Malaysia
3Department of Medicine, Faculty of
Medicine, University of Malaya, Kuala Lumpur, Malaysia
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