EC Microbiology

Introduction: Intestinal coccidiosis is a common opportunistic parasitic infection among patients living with HIV and represents an important cause of digestive morbidity, particularly in low-resource settings. It is mainly caused by Cryptosporidium spp., Cystoisospora belli and Cyclospora cayetanensis, which are transmitted through the fecal-oral route. In HIV-infected patients, these infections may present with acute or chronic diarrhea, sometimes severe and prolonged, leading to dehydration, malabsorption and weight loss. Despite advances in HIV management, intestinal coccidiosis remains frequent and often underdiagnosed. Stool parasitological examination remains essential for its diagnosis.

Materials and Methods: A descriptive study was conducted from January 2022 to November 2025 in the Parasitology Laboratory of Hassan II University Hospital in Fez. HIV-positive patients who underwent stool parasitological examination, either in screening context or because of diarrhea, were included. Diagnosis relied on direct microscopic examination, concentration techniques (Ritchie method) and modified Ziehl-Neelsen staining for identification of intestinal coccidia.

Results: A total of 31 HIV-positive patients were included, with a mean age of 38.5 years and a female predominance (58%). Stool examination was mainly performed as part of screening (74%). Intestinal coccidia were detected in 25 patients, corresponding to an overall prevalence of 80.6%, with comparable positivity rates between diarrheic patients and those investigated for screening.

Conclusion: Intestinal coccidiosis remains frequent among HIV-infected patients and constitutes a significant cause of digestive morbidity. Stool parasitological examination remains indispensable for diagnosis, particularly in low-resource settings. These findings highlight the crucial role of parasitology laboratories in screening and managing HIV patients.

Keywords: Cryptosporidiosis; Cyclosporiasis; HIV; Intestinal coccidiosis; Stool Parasitological Examination

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