Research Article	Intestinal Parasites and HIV Co-infections in Mogadishu (Somalia): A Retrospective Evaluation of Four-Year Follow-up Data Mogadişu’da (Somali) İntestinal Parazitler ve HIV Ko-enfeksiyonları: Dört Yıllık Takip Verilerinin Retrospektif Değerlendirmesi *Faduma NUR ADAN^1[ID], Marian MUSE OSMAN^2[ID], Ahmed Muhammad BASHIR^3[ID], İsmail Selçuk AYGAR^4[ID], Sadettin ER^5[ID], Oktay SARI^6[ID], Onur BAHÇECİ^7[ID], Tuğrul HOŞBUL^8[ID], Ümit SAVAŞÇI^9[ID], Mahamat ADAM MOUSSA^10 [ID], Fatih ŞAHİNER^11[ID] Abstract This study aimed to evaluate the frequency and distribution characteristics of intestinal parasites and human immunodeficiency virus (HIV) seropositivity in children and adults presenting to a tertiary care hospital in Mogadishu, Somalia. The study included the results of all parasitological stool examinations conducted between November 2015 and November 2019. In addition, the HIV serological status of individuals was retrospectively analyzed. During the four-year study period, at least one intestinal parasite was found in stool samples from 1,538 (6.23%) of 24,676 individuals. A total of 1,570 intestinal parasites were detected in 1,538 patients (42.5% aged 10 years and under), including 44 parasites in mixed infections and 20 parasites in 10 patients at different times. The most common intestinal parasite was Giardia lamblia (n=730, 46.5%), followed by Entamoeba histolytica (n=677, 43.1%), Ascaris lumbricoides (n=30, 1.9%), Hymenolepis nana (n=28, 1.78%), Trichomonas hominis (n=26, 1.66%), Trichuris trichiura (n=26, 1.66%), and eight other species (n=53, 3.38%). HIV seropositivity was present in 1.12% (4/358) of the patients with parasitic infections and 0.39% (23/5868) of those with a negative stool test (p=0.0655). Intestinal parasitic infections increased in December and January. A. lumbricoides and T. trichiura were significantly increased in patients from refugee camps. This study included the most comprehensive data on the distribution and characteristics of intestinal parasitic infections and HIV seroprevalence in Somalia over the last 30 years. We consider that these data will contribute to the risk analysis and planning of preventive health policies. Keywords: Immigrants, Refugees, Child health, Giardiasis, Amoebiasis. Özet Bu çalışmada Somali Mogadişu’da bulunan bir üçüncü basamak hastanesine başvuran çocuk ve yetişkinlerde intestinal parazitlerinin görülme sıklığı ve dağılım özellikleri ile insan immün yetmezlik virusu (HIV) seropozitifliğinin değerlendirilmesi amaçlanmıştır. Çalışma, Kasım 2015 ile Kasım 2019 arasında yapılan tüm parazitolojik dışkı incelemelerinin sonuçlarını içermektedir. Ek olarak, bireylerin HIV serolojik durumları retrospektif olarak incelenmiştir. Dört yıllık çalışma süresi boyunca, 24.676 kişiden 1.538'inin (%6.23) dışkı örneklerinde en az bir intestinal parazit varlığı bulundu. Çoklu enfeksiyonlarda 44 parazit ve 10 hastada farklı zamanlarda saptanan 20 parazit dahil olmak üzere 1.538 hastada (%42.5'i 10 yaş ve altı) toplam 1.570 intestinal parazit tespit edildi. En yaygın tespit edilen intestinal parazit Giardia lamblia 730 (%46.5) iken, diğerleri sırasıyla Entamoeba histolytica 677 (%43.1), Ascaris lumbricoides 30 (%1.9), Hymenolepis nana 28 (%1.78), Trichomonas hominis 26 (%1.66), Trichuris trichiura 26 (%1.66) ve diğer sekiz tür (n=53, %3.38) idi. Paraziter enfeksiyonu olan hastaların %1,12'sinde (4/358), dışkı testi negatif olanların ise %0,39'unda (23/5868) HIV seropozitifliği mevcuttu (p=0,0655). İntestinal parazit enfeksiyonları Aralık ve Ocak aylarında artmıştı. A. lumbricoides ve T. trichiura mülteci kamplarından gelen hastalarda önemli oranda yüksekti. Bu çalışma, Somali'de intestinal paraziter enfeksiyonların dağılımı ve özellikleri ile HIV seroprevalansı hakkında son 30 yıldaki en kapsamlı verileri içermektedir. Bu verilerin risk analizine ve koruyucu sağlık politikalarının planlanmasına katkı sağlayacağını düşünüyoruz. Anahtar kelimeler: Göçmenler, Mülteciler, Çocuk sağlığı, Giardiyazis, Amibiyazis. Figure 1. Overview of the study group and positivity rates in different subgroups. Figure 1 png Şekil 1. Çalışma grubuna genel bakış ve farklı alt gruplarda pozitiflik oranları. Şekil 1 png Figure 2. Patients with persistent or re-infections during the four-year follow-up. (N: a negative test result) Figure 2 png Şekil 2. Dört yıllık takip sürecinde persistan veya re-enfeksiyonu olan hastalar. (N: negatif test sonucu) Şekil 2 png Figure 3. Distribution of parasitic infections by month over the four-year period. *Red line indicates all reported tests; 26,159. **Green line represents the positivity rate over all reported tests. ***Blue line shows the distribution of all 1,570 parasites). Figure 3 png Şekil 3. Dört yıllık periyot sürecinde paraziter enfeksiyonların aylara göre dağılımı. *Kırmızı çizgi, raporlanan tüm testleri gösterir; 26.159. **Yeşil çizgi, raporlanan tüm testlerdeki pozitiflik oranını temsil eder. ***Mavi çizgi 1.570 parazitin tümünün dağılımını göstermektedir). Şekil 3 png
DOI: 10.46683/jmvi.2021.39
Article in English
^1Department of Infectious Disease and Clinical Microbiology, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia. ^2Department of Public Health, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia. ^3Department of Internal Medicine, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia. ^4Department of Medical Microbiology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye. ^5Department of General Surgery, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia. ^6Department of Family Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye. ^7Department Medical Biochemistry, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia. ^8Department of Medical Microbiology, Gulhane Medical Faculty, University of Health Sciences, Ankara, Türkiye. ^9Department of Infectious Disease, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye. ^10Higher School of Health Sciences and Techniques, King Faisal University, N'Djamena, Chad. ^11Department of Medical Microbiology, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia.
*Corresponding author Faduma Nur Adan; MD, Department of Infectious Disease and Clinical Microbiology, Mogadishu Somalia-Turkey Recep Tayyip Erdoğan Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia. E-mail: rayaann460@gmail.com
Received: 23.09.2021 Accepted: 26.10.2021 Published: 28.10.2021
Cite as: Nur Adan F, Muse Osman M, Bashir AM, Aygar İS, Er S, Sarı O, Bahçeci O, Hoşbul T, Savaşçı Ü, Adam Moussa M, Şahiner F. Intestinal Parasites and HIV Co-infections in Mogadishu (Somalia): A Retrospective Evaluation of Four-Year Follow-up Data. J Mol Virol Immunol 2021; 2(4): 123-135.
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Cited by 3 articles*, 0 book chapter.
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[2]* Tekin K, Abdi Osman M, Nur Adan F, Sümbül HE, Şahiner F. Acid-Fast Bacilli Smear Positivity and HBV, HCV, HIV, and Syphilis Co-infections between 2015 and 2019 in Mogadishu, Somalia. Life Med Sci 2022; 1(4): 140-146. doi: 10.54584/lms.2022.20
[3]* Ülgü MM, Ali Adam A, Karakuş H, Sümbül HE. An Example of the Importance of Electronic Health Records from Mogadishu, Somalia: Hepatitis B Prevalence and Co-infections with Hepatitis C. J Mol Virol Immunol 2023; 4(3): 115-123. doi: 10.46683/jmvi.2023.77
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