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首页> 外文学位 >Recreational water contact as a risk factor for Cryptosporidium exposure among persons with HIV/AIDS in Baltimore, Maryland.
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Recreational water contact as a risk factor for Cryptosporidium exposure among persons with HIV/AIDS in Baltimore, Maryland.

机译：娱乐水接触是马里兰州巴尔的摩市艾滋病毒/艾滋病患者接触隐孢子虫的危险因素。

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The purpose of this dissertation is to provide evidence of recreational water contact as a specific route of microbial exposure to Cryptosporidium for persons with HIV/AIDS for whom Cryptosporidium is an important opportunistic agent. The objectives of this research were to (1) Characterize patterns of recreational water activity in HIV/AIDS patients; (2) Sample and test recreational waters used by HIV/AIDS patients, as well as wild-caught blue crabs caught from Baltimore waters to identify them as reservoirs of Cryptosporidium; and (3) Evaluate risks of self-reported recreational water activity with gastrointestinal illness (chronic and/or intermittent diarrhea and associated symptoms), relative to the U.S. EPA acceptable levels of risks for waterborne pathogens.;For Objective 1, a detailed cross-sectional study of an outpatient HIV/AIDS clinic population was undertaken. Objective 2 was accomplished by identification of the most frequently used recreational water sites identified from the questionnaire in Objective 1, and assessment of monthly collected water samples for the presence of Cryptosporidium oocysts. Objective 3 was achieved by analyzing the questionnaire data from Objective 1 for recent self-reported gastrointestinal diarrhea and self-reported recreational water activity, and other risk factors.;Results of my research: (1) Provide the first documentation that persons with HIV/AIDS in the Baltimore region are actively engaged in recreational water activities. Patients also reported consuming wild-caught fish and crabs from these waters; (2) Found viable Cryptosporidium oocysts on surface washes of blue crabs caught in local waters in Baltimore at the Middle Branch Park of the Patapsco River, and in local waters frequently used by the HIV/AIDS population for recreational water activities, and (3) Found no association between self-reported gastrointestinal illness (i.e., chronic and/or intermittent diarrhea and associated symptoms) and self-reported recreational water activity.;In conclusion, this research provides evidence to support the hypothesis that persons with HIV/AIDS are exposed to Cryptosporidium from recreational water activities in local water bodies within the Baltimore watersheds of the Chesapeake Bay. HIV/AIDS patients at risk for severe cryptosporidiosis should avoid recreational water contact, and patients reporting chronic and/or intermittent diarrhea should be further queried regarding potential exposures to enteric parasites such as Cryptosporidium.
机译：本论文的目的是提供娱乐性水接触的证据，作为艾滋病毒/艾滋病患者隐孢子虫是重要的机会药物的微生物接触隐孢子虫的一种特殊途径。这项研究的目的是（1）表征HIV / AIDS患者娱乐性水活动的模式； （2）对艾滋病毒/艾滋病患者使用的娱乐水以及从巴尔的摩水捕获的野生蓝蟹进行取样和测试，以将其识别为隐孢子虫的水库； （3）相对于美国EPA可接受的水生病原体风险水平，评估自我报告的娱乐性水活动与胃肠道疾病（慢性和/或间歇性腹泻及相关症状）的风险。对于目标1，详细的交叉对门诊艾滋病毒/艾滋病门诊患者进行了横断面研究。通过确定从目标1的调查表中识别出的最常用的娱乐水站点，并评估每月收集的水样中是否存在隐孢子虫卵囊，来实现目标2。目标3是通过分析目标1中有关最近自我报告的胃肠道腹泻和自我报告的娱乐水活动以及其他危险因素的问卷数据而实现的。研究结果：（1）提供第一份有关艾滋病毒/巴尔的摩地区的艾滋病积极从事娱乐性水上活动。患者还报告从这些水域食用野生捕捞的鱼和螃蟹。 （2）在Patapsco河中支公园的巴尔的摩当地水域中以及在HIV / AIDS人口经常用于娱乐性水上活动的当地水域中捕获的蓝蟹表面清洗中发现了可行的隐孢子虫卵囊，以及（3）未发现自我报告的胃肠道疾病（即慢性和/或间歇性腹泻及相关症状）与自我报告的娱乐性水活动之间没有关联；总之，这项研究提供了证据支持艾滋病毒/艾滋病感染者的假说切萨皮克湾巴尔的摩分水岭的局部水体中进行娱乐性水活动而产生的隐孢子虫。处于严重隐孢子虫病风险中的HIV / AIDS患者应避免娱乐性水源接触，应进一步询问报告慢性和/或间歇性腹泻的患者有关肠寄生虫（如隐孢子虫）的潜在暴露情况。

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