Linking Diarrhoea & HIV

• Diarrhoea is a symptom of infection caused by a host of bacterial, viral and parasitic organisms most of which can be spread by contaminated water.
• Diarrhoea affects 90% of people living with HIV/AIDS and results in significant morbidity and mortality^1,2.
• Diarrhoea is one of the leading causes of morbidity and mortality among HIV-infected children³.
  
• In HIV-positive children, diarrhoea is often the result of frequently aggressive common childhood infections caused by pathogens such as Campylobacter, E. coli, Salmonella, Shigella or rotavirus⁴.
• Persistent diarrhoea occurs with increased frequency in HIV-infected children, and is associated with an 11-fold increase in mortality compared to uninfected children⁵.
• In Africa, diarrhoea is four times more common among children with HIV and seven times more common among adults with HIV than their HIV-negative household members⁶.
• A study found that although common diarrhoea causing enteric pathogens are found in many babies, HIV-positive babies with acute diarrhoea were six times more likely to develop persistent diarrhoea. HIV-negative babies born to HIV positive mothers were also at 3.5 times greater risk of developing recurrent bouts of diarrhoea than babies born to HIV-negative mothers⁷.
• A study compiled case reports of cryptosporidiosis and found a mortality rate of 46% in AIDS patients and 29% in patients with other immunodeficiencies⁸.
• A study of HIV-infected persons and their families in Uganda showed that use of a simple, home-based safe water system reduced the incidence of diarrhoeal episodes by 25%, the number of days with diarrhoea by 33%, and the frequency of visible blood or pus in stool⁹.
• In a study among HIV-infected persons in Uganda, use of safe water decreased diarrhoeal illness by 36%.

References

1. Katabira, E.T. 1999. Epidemiology and management of diarrheal disease in HIV-infected patients. International Journal of Infectious Disease 3(3):164-7

2. Monkemuller, K.E. and Wilcox, C.M. 2000. Investigation of Diarrhea in AIDS. Canadian Journal of Gastroenterology 14(11):933-40

3. http://www.pepfar.gov/guidance/78265.htm

4. Partners in Health, The PIH Guide to the Community-Based Treatment of HIV in Resource-Poor Settings (Revised Second Edition), Partners in Health, Boston, 2008

5. Tindyebwa, D., et al. 2004. Common Clinical Conditions Associated with HIV', in: Handbook on Paediatric AIDS in Africa

6. Mermin J et al. 2005. Developing an evidence-based, preventive care package for persons with HIV in Africa

7. Keusch GT et al.1992. Persistent diarrhea associated with AIDS. Acta Paediatrics, 381:45-48

8. Fayer R. and B. L. P. Ungar. 1986. Cryptosporidium spp. and cryptosporidiosis. Microbiol Res.50:458-483

9. Lule, J.R. et al. 2005. Effect of home-based water chlorination and safe storage on diarrhea among persons with human immunodeficiency virus in Uganda. Am J Trop Med Hyg. 73(5):926-33