Purpose

Cryptosporidium is implicated in diarrhea epidemics in many parts of the world and is said to be the most common protozoan cause of diarrhea among people living with HIV/AIDS (PLWHA) globally. To provide data on the burden of Cryptosporidium infections among Nigerians living with HIV/AIDS, we reported the prevalence, geographic distribution and Cryptosporidium species diversity among this population in Nigeria.

Methods

We used the PRISMA guidelines to perform a systematic review and meta-analysis of articles published between January 1, 1995 and April 21, 2020. Pooled estimate (PE), heterogeneity, quality of each study and publication bias were determined using the random-effects model, Cochran’s Q test, the 9 point Joanna Briggs Institute Critical Appraisal Instrument and the Egger’s regression asymmetry test, respectively.

Results

Forty-six articles reported 2612 positive cases of Cryptosporidium infections from 12,756 PLWHA examined in 20 Nigerian States and the Federal Capital Territory. Overall pooled estimate was 14.5% (95% CI 10.4–19.9) with a range of 0.3% (95% CI 0.0–1.8) to 43.7% (95% CI 35.6–52.3) across sub-groups, with the PEs in relation to CD4⁺ T cell count, species and age showing significant variations at p < 0.05. Cryptosporidium hominis was the most prevalent (3.5%, 95% CI 2.3–5.2) of the six Cryptosporidium species reported in Nigeria.

Conclusion

Cryptosporidium infections are moderately prevalent among PLWHA in Nigeria with the highest regional prevalence in the north-east. In addition to personal hygienic practices, the inclusion of Cryptosporidium screening as part of HIV/AIDS clinics in Nigeria will reduce the burden of the parasite among PLWHA in Nigeria.

中文翻译：

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尼日利亚艾滋病毒/艾滋病感染者隐孢子虫感染的流行病学：系统审查和荟萃分析的结果。

目的

隐孢子虫与世界许多地区的腹泻流行有关，据说是全球艾滋病毒/艾滋病感染者 (PLWHA) 腹泻最常见的原生动物原因。为了提供有关感染 HIV/AIDS 的尼日利亚人中隐孢子虫感染负担的数据，我们报告了尼日利亚该人群中的流行率、地理分布和隐孢子虫物种多样性。

方法

我们使用 PRISMA 指南对 1995 年 1 月 1 日至 2020 年 4 月 21 日期间发表的文章进行系统评价和荟萃分析。使用随机效应确定汇总估计 (PE)、异质性、每项研究的质量和发表偏倚模型、Cochran 的Q检验、Joanna Briggs Institute 的 9 点关键评估工具和 Egger 的回归不对称检验，分别。

结果

46 篇文章报告了 2612 例隐孢子虫感染阳性病例，这些病例来自在尼日利亚 20 个州和联邦首都直辖区检查的 12,756 名感染者。跨亚组的总体汇总估计为 14.5%（95% CI 10.4-19.9），范围为 0.3%（95% CI 0.0-1.8）至 43.7%（95% CI 35.6-52.3），PE 与CD4 ⁺ T 细胞计数、物种和年龄在p  < 0.05处显示出显着变化。在尼日利亚报道的六种隐孢子虫中，人型隐孢子虫是最普遍的（3.5%，95% CI 2.3-5.2）。

结论

隐孢子虫感染在尼日利亚的 PLWHA 中中等流行，东北部地区流行率最高。除了个人卫生习惯外，将隐孢子虫筛查作为尼日利亚艾滋病毒/艾滋病诊所的一部分，将减轻尼日利亚感染者感染寄生虫的负担。