Amany Ibrahim Shehata Hassan
High Institute of Public Health
Title: Opportunistic parasitoses among Egyptian hemodialysis patients in relation to CD4+ T-cell counts: a comparative study
Submitted Date: 13/06/2019
Biography
Amany Ibrahim Shehata Hassan has got- her M.B.B.Ch in 1988 from Faculty of Medicine, Alexandria University, Egypt. She has got her Master and doctor degrees of Public Health Majoring Parasitology from the High Institute of Public Health, Alexandria University, Egypt in1995 and in 2002 respectively. He is a lecturer of Parasitology in the Tropical Health Department, HIPH. She is an expert in field studies concerning endemic parasitic diseases in Egypt, especially among vulnerable population groups as mentally challenged individuals. She was one of the members of Kafr El-Sheikh team (PI: Prof. Dr. Rashida Barakat) in the Schistosomiasis Research Project (SRP) from 1990 to 1994. She was nominated by the WHO to participate in the course: “Capacity Building in Research Methods and Ethics. Organized by WHO & TDR & IPT, in Tunisia in 2016. She has published many papers in reputed journals.rn
Abstract
Background: Patients with chronic renal failure undergoing hemodialysis (HD) are rnimmunocompromised individuals suffering from a change in CD4+T lymphocytes phenotype and proliferation parameters. Several parasites were documented to cause serious illness among immune-compromised individuals. Although few reports are available on the frequency of opportunistic parasitosis among HD patients yet there is paucity of data on the correlations of the CD4 levels and these infections. Aim: Therefore, this study was conducted to determine the prevalence of the different parasites among HD patients and to try to elucidate the possible associations between parasitosis and the CD4 cell counts. Methods: A comparative cross-sectional study was carried out on 120 HD patients and 100 apparently healthy individuals. Stool samples collected were stained by Trichrome, Quick hot gram chromotrope and modified acid- fast stains. A complete blood picture was done for hemoglobin and CD4 counts estimation. Serum was tested for Toxoplasma immunoglobulins. Results: HD patients presented with a significantly higher rates of both IPIs and toxoplasmosis than healthy individuals (52.5% &33.3% respectively vs 12% & 8% respectively). The most prevalentrn rn rn rnparasites detected were Cryptosporidium (32.5%), B. hominis (24.2%) and microsporidia (11.7%). The majority of HD patients (95%) were anemic. Significantly higher rates of cryptosporidiosis were observed among patients with counts <350 than those with higher counts. HD patients with low CD4 count (< 200) presented with significantly higher rates of both microsporidium and T.gondii infections (28.6% and 61.9% respectively). Conclusion: HD patients are at high risk of infection with parasites. Parasitism is closely related to the degree of compromise of their immunity. So routine screening, treatment of these parasites, management of anemia and raising the immune status of these patients is advocated for improving their well-being.rn