Article
Prevalence of Pneumocystis jirovecii in HIV positive and HIV negative hospital patients in Cameroon
Prävalenz von Pneumocystis jirovecii in HIV-positiven und HIV-negativen Krankenhauspatienten in Kamerun
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Published: | June 2, 2010 |
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Objective: Except for South Africa, the prevalence of Pneumocystis jirovecii in African countries is almost unknown. Therefore, we analyzed sputa of HIV-positive and HIV-negative patients in a Cameroonian hospital for Pneumocystis jirovecii.
Methods: We examined induced sputum samples from 237 inpatients of the Regional Hospital Limbe (tertiary referral hospital for the Southwest Region of Cameroon) for the presence of Pneumocystis jirovecii (P. jirovecii). P. jirovecii was detected by mitochondrial transcribed large subunit rRNA gene nested PCR (mtLSU nPCR). The mtLSU nPCR allows to distinguish between low parasite loads (usually Pneumocystis colonization, only second PCR step positive) and high parasite loads (usually Pneumocystis pneumonia, first and second PCR step positive).
Results: 129 of 237 patients were HIV-positive and 108 were HIV-negative. Of the 129 HIV-positive patients, 108 (83.7%) had a cough. Of the 108 HIV-negative patients, 73 (67.6%) had a cough. P. jirovecii was detected in 53 of the HIV-positive (41.1%) and in 21 of the HIV-negative patients (19.4%) from Cameroon (p=0.0002). Overall, P. jirovecii DNA was detected in 75 of 237 (31.6%) patients. Cough was present in equal frequency in both groups.
Conclusions: To our knowledge, this is the first study describing the presence of P. jirovecii in Cameroon. Prevalence of P. jirovecii was approximately twice as high in HIV-positive patients, as in HIV-negative patients. Whether the P. jirovecii positive HIV patients were merely Pneumocystis carriers or had Pneumocystis pneumonia could not be judged conclusively. Testing of the isolates for Co-trimoxazole resistance is ongoing.