4 Gastrointestinal opportunistic infections: 4. Gastrointestinal opportunistic infections

Asymptomatic Cryptosporidiosis in Children Living with HIV

Children living with human immunodeficiency virus (HIV) have an increased risk of opportunistic Cryptosporidium infection. Cryptosporidium usually causes chronic diarrhea that may lead to impaired growth and cognitive function in children. This study aimed to estimate the prevalence of cryptosporidiosis in children, describe its clinical characteristics, and the risk factors. A cross-sectional study involving children aged 6 months to 18 years old with confirmed HIV infection was carried out in Sardjito General Hospital, Yogyakarta. Diagnosis of cryptosporidiosis was made by PCR of 18S rRNA after being screened by microscopic examination. The clinical characteristics and risk factors were obtained from medical records and structured questionnaires. A total of 52 participants were included in the final analysis. The prevalence of cryptosporidiosis was 42.3%. Approximately 68% of the HIV children with cryptosporidiosis were asymptomatic, while those who reported symptoms showed weight loss and diarrhea. Independent risk factors of cryptosporidiosis were diarrhea (AOR 6.5; 95% CI 1.16-36.67), well water as drinking water source (AOR 6.7; 95% CI 1.83-24.93), and drink untreated water (AOR 5.8; 95% CI 1.04-32.64). A high prevalence of asymptomatic cryptosporidiosis was observed among children with HIV infection and PCR screening of Cryptosporidium in high-risk children is advisable.

Palm Kernel Cake Oligosaccharides Acute Toxicity and Effects on Nitric Oxide Levels Using a Zebrafish Larvae Model

One of the beneficial effects of non-digestible oligosaccharides (NDOs) is their anti-inflammatory effects on host animals. While conventional animal studies require that analysis be done after samples have been taken from the host, zebrafish larvae are optically transparent upon hatching and this provides an opportunity for observations to be made within the living zebrafish larvae. This study aimed to take advantage of the optical transparency of zebrafish larvae to study the nitric oxide (NO) reducing effects of NDOs through the use of lipopolysaccharide (LPS) from Salmonella enterica serovar (ser.) Enteritidis (S. Enteritidis) to induce cardiac NO production. Prior to running the above experiment, an acute toxicity assay was conducted in order to determine the appropriate concentration of oligosaccharides to be used. The oligosaccharides tested consisted of oligosaccharides which were extracted from palm kernel cake with a degree of polymerization (DP) equal to or less than six (OligoPKC), commercial mannanoligosaccharide (MOS) and commercial fructooligosaccharide (FOS). Acute toxicity test results revealed that the OligoPKC has a LC₅₀ of 488.1 μg/ml while both MOS and FOS were non-toxic up to 1,000 μg/ml. Results of the in vivo NO measurements revealed that all three NDOs were capable of significantly reducing NO levels in LPS stimulated zebrafish embryos. In summary, at 250 μg/ml, OligoPKC was comparable to MOS and better than FOS at lowering NO in LPS induced zebrafish larvae. However, at higher doses, OligoPKC appears toxic to zebrafish larvae. This implies that the therapeutic potential of OligoPKC is limited by its toxicity.