Prevalence and distribution of parasitic infections among HIV-positive adults attending antiretroviral therapy clinics in South-West Nigeria

Parasitic infections constitute a major cause of morbidity among people living with HIV (PLHIV), especially in resource-limited settings. This study investigated the prevalence, distribution, diagnostic awareness and treatment practices of parasitic infections among HIV-positive adults attending antiretroviral therapy (ART) clinics in three tertiary hospitals across South-West Nigeria. A cross-sectional design was used to collect socio-demographic data, clinical history, diagnostic awareness, and treatment preferences through structured questionnaires. Stool and blood samples were analysed for intestinal and blood-borne parasitic infections using standard microscopy techniques. Overall, 64 (38.3%) out of the 167 HIV-positive participants tested positive for at least one parasitic infection. Intestinal parasites accounted for 15.6% of cases, blood-borne parasites for 12.6%, while 10.2% had co-infections. Entamoeba histolytica (8.4%) and Giardia lamblia (4.8%) were the most prevalent intestinal parasites, whereas Plasmodium falciparum (12.6%) was the only blood-borne parasite detected. Less than half (43.7%) of participants had previously undergone laboratory testing for parasitic infections, althogh the majority (89.8%) expressed willingness to adopt improved diagnostic techniques. Conventional medicine was the preferred treatment approach, while 27.5% of the participants preferred a combination of herbal and conventional therapies. Although infection prevalence appeared higher among females, urban residents and participants aged 40 years and above, no statistically significant association ( p > 0.05) was observed between socio-demographic characteristics and infection status. The findings demostrated that parasutuc infections remain common among PLHIV in South-West Nigeria despite widespred ART use. Integrating routine parasitic screening with more sensitive diagnostic approaches into HIV care could facilitate early detection and improve patient management in endemic settings.