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Chronic diarrhoea in HIV-1-infected adults in Nairobi, Kenya: evaluation of risk factors and the WHO treatment algorithm

We evaluated a modified WHO algorithm for the management of chronic diarrhoea in ambulatory HIV-1-infected adults that included the use of norfloxacin, metronidazole and loperamide. In a cohort of 380 HIV-1-infected adults in Nairobi, Kenya, the incidence of chronic diarrhoea was 286 cases/1000 person-years; 85% of chronic diarrhoea episodes responded completely to therapy. Although these findings appear to validate the modified WHO chronic diarrhoea algorithm, randomized controlled trials may better define the indication for antibiotics in chronic diarrhoea.