Cryptosporidiosis and Cyclosporiasis in Diarrhoeic HIV Patients at a Secondary Hospital in Nasarawa State, North Central Nigeria

Cryptosporidium and Cyclospora are coccidian protozoa that cause chronic and debilitating diarrhoea in immunocompromised patients, particularly those living with HIV/AIDS in resource-limited settings. This study investigates the prevalence of cryptosporidiosis and cyclosporiasis among diarrhoeic HIV-positive patients attending a secondary hospital in Nasarawa State, North Central Nigeria. A cross-sectional design was adopted, enrolling 200 HIV-positive patients presenting with diarrhoea from the ART clinic at a state general hospital in Lafia. Stool samples were examined using the modified Ziehl-Neelsen staining technique to detect Cryptosporidium oocysts and Cyclospora cayetanensis oocysts. Data on CD4 count, antiretroviral therapy status, type of diarrhoea, nutritional status, and water source were collected from patient records and structured interviews. Recent evidence from 2020 to 2024 highlights the underdiagnosis of both parasites in Nigerian HIV clinics, largely due to the limited routine use of acid-fast staining in gastrointestinal workups. This study aims to quantify coinfection rates and assess clinical correlates of infection, particularly CD4 count thresholds below which parasitic diarrhoea predominates. Findings will inform the Nasarawa State Ministry of Health and the infectious disease unit of the study hospital on the need for routine coccidian screening in HIV care. Keywords: Cryptosporidium, Cyclospora, HIV-positive patients, diarrhoeic illness, Nasarawa State.