Microbiological assessment reveals that Salmonella, Shigella and Campylobacter infections are widespread in HIV infected and uninfected patients with diarrhea in Mozambique

PLOS glob. public health; 3 (5), 2023
Ano de publicação: 2023

Diarrhea is an important cause of hospitalizations in Mozambique. However, little attention has beenpaid to the impact HIV infection on the prevalence or clinical manifestations of enteric bacterial infections. This study aimed to determine the prevalence of Salmonella spp., Shigella spp. and Campylobacter spp. in HIV-infected and HIV-uninfected patients with diarrhea, identify risk factors for infection, and explore the association between HIV sta tus, viral load, and bacterial prevalence. We conducted a case-control study at the Centro de Sau ´de de Mavalane andCentro deSau ´de 1˚deMaioinMaputo, Mozambique, from November2021toMay2022.Werecruited 300patients, including 150 HIV-infected (cases) and150HIV-uninfected patients (controls), aged between 0–88 years, presenting with diar rhea. Stool samples were collected for bacterial isolation through culture, and for each HIV infected patient, 4 ml of venous blood were obtained for viral load detection through PCR. A total of 129 patients (43.0%) had at least one bacterial infection. The prevalence of Salmo nella spp., Shigella spp. and Campylobacter spp. was 33.0% (n = 99), 15.0% (n = 45) and 4.3%(n=13), respectively. The prevalence of any bacterial infection did not differ signifi cantly between HIV-infected (45.3%, n = 68) and HIV-uninfected patients (40.7%, = 61) (p = 0.414). Overall, having 2–3 symptoms of enteric disease (p = 0.008) and a basic education (p =0.030) were factors associated with bacterial infection. Of the 148 patients for whom HIV-1 RNAlevels wereavailable, 115 had copy numbers �75. Another 13had levels between 76and1,000andtheremaining 20hadanaverage of327,218.45 copies/ml. Bivar iate logistic regression found that Shigella spp. were associated with HIV (p = 0.038)

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