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Oduro D, Baafi E, Opoku-Agyeman P, Adams T, Okai AA, Bruku S, Kyei S, Banahene P, Danso-Coffie C, Boafo E, Yeboah R, Futagbi G, Duah-Quashie NO. Enteric parasites Cyclospora cayetanensis and Cryptosporidium hominis in domestic and wildlife animals in Ghana. Parasit Vectors 2024; 17:199. [PMID: 38698452 PMCID: PMC11064306 DOI: 10.1186/s13071-024-06225-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/01/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Enteric parasitic infections remain a major public health problem globally. Cryptosporidium spp., Cyclospora spp. and Giardia spp. are parasites that cause diarrhea in the general populations of both developed and developing countries. Information from molecular genetic studies on the speciation of these parasites and on the role of animals as vectors in disease transmission is lacking in Ghana. This study therefore investigated these diarrhea-causing parasites in humans, domestic rats and wildlife animals in Ghana using molecular tools. METHODS Fecal samples were collected from asymptomatic school children aged 9-12 years living around the Shai Hills Resource Reserve (tourist site), from wildlife (zebras, kobs, baboons, ostriches, bush rats and bush bucks) at the same site, from warthogs at the Mole National Park (tourist site) and from rats at the Madina Market (a popular vegetable market in Accra, Ghana. The 18S rRNA gene (18S rRNA) and 60-kDa glycoprotein gene (gp60) for Cryptosporidium spp., the glutamate dehydrogenase gene (gdh) for Giardia spp. and the 18S rDNA for Cyclospora spp. were analyzed in all samples by PCR and Sanger sequencing as markers of speciation and genetic diversity. RESULTS The parasite species identified in the fecal samples collected from humans and animals included the Cryptosporidium species C. hominis, C. muris, C. parvum, C. tyzzeri, C. meleagridis and C. andersoni; the Cyclopora species C. cayetanensis; and the Gardia species, G. lamblia and G. muris. For Cryptosporidium, the presence of the gp60 gene confirmed the finding of C. parvum (41%, 35/85 samples) and C. hominis (29%, 27/85 samples) in animal samples. Cyclospora cayetanensis was found in animal samples for the first time in Ghana. Only one human sample (5%, 1/20) but the majority of animal samples (58%, 51/88) had all three parasite species in the samples tested. CONCLUSIONS Based on these results of fecal sample testing for parasites, we conclude that animals and human share species of the three genera (Cryptosporidium, Cyclospora, Giardia), with the parasitic species mostly found in animals also found in human samples, and vice-versa. The presence of enteric parasites as mixed infections in asymptomatic humans and animal species indicates that they are reservoirs of infections. This is the first study to report the presence of C. cayetanensis and C. hominis in animals from Ghana. Our findings highlight the need for a detailed description of these parasites using high-throughput genetic tools to further understand these parasites and the neglected tropical diseases they cause in Ghana where such information is scanty.
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Affiliation(s)
- Daniel Oduro
- Department of Animal Biology and Conservation Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Esther Baafi
- Department of Animal Biology and Conservation Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Philip Opoku-Agyeman
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Tryphena Adams
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Akweley Abena Okai
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Selassie Bruku
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Sandra Kyei
- Department of Animal Biology and Conservation Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Phillip Banahene
- Department of Animal Biology and Conservation Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Caleb Danso-Coffie
- Department of Animal Biology and Conservation Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Emmanuel Boafo
- Department of Animal Biology and Conservation Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Rhoda Yeboah
- Department of Animal Biology and Conservation Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Godfred Futagbi
- Department of Animal Biology and Conservation Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Nancy Odurowah Duah-Quashie
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana.
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Negi S, Hashimoto-Hill S, Alenghat T. Neonatal microbiota-epithelial interactions that impact infection. Front Microbiol 2022; 13:955051. [PMID: 36090061 PMCID: PMC9453604 DOI: 10.3389/fmicb.2022.955051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/31/2022] [Indexed: 11/13/2022] Open
Abstract
Despite modern therapeutic developments and prophylactic use of antibiotics during birth or in the first few months of life, enteric infections continue to be a major cause of neonatal mortality and morbidity globally. The neonatal period is characterized by initial intestinal colonization with microbiota and concurrent immune system development. It is also a sensitive window during which perturbations to the environment or host can significantly impact colonization by commensal microbes. Extensive research has demonstrated that these early life alterations to the microbiota can lead to enhanced susceptibility to enteric infections and increased systemic dissemination in newborns. Various contributing factors continue to pose challenges in prevention and control of neonatal enteric infections. These include alterations in the gut microbiota composition, impaired immune response, and effects of maternal factors. In addition, there remains limited understanding for how commensal microbes impact host-pathogen interactions in newborns. In this review, we discuss the recent recognition of initial microbiota-epithelial interactions that occur in neonates and can regulate susceptibility to intestinal infection. These studies suggest the development of neonatal prophylactic or therapeutic regimens that include boosting epithelial defense through microbiota-directed interventions.
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Nipa NJ, Aktar N, Hira HM, Akter F, Jahan D, Islam S, Etando A, Abdullah A, Chowdhury K, Ahmad R, Haq A, Haque M. Intestinal Parasitic Infections Among Pediatric Patients in a Metropolitan City of Bangladesh With Emphasis on Cryptosporidiosis. Cureus 2022; 14:e26927. [PMID: 35865179 PMCID: PMC9293268 DOI: 10.7759/cureus.26927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Gastrointestinal parasitic infections are one of the global health concerns in developing countries like Bangladesh. Among them, Cryptosporidium spp. plays an essential role in causing diarrhea, malnutrition, and poor cognitive function, especially in children. This study was conducted to identify the frequency of Cryptosporidium cases and other parasitic agents. Methods A cross-sectional observational study was conducted among 219 hospitalized children with diarrhea. The conventional microscopic technique was applied for parasitic detection. Particular staining (modified Ziehl-Neelsen) procedure was performed to identify oocysts of Cryptosporidium spp. A polymerase chain reaction (PCR) was performed to determine the SSU rRNA and gp60 gene of Cryptosporidium. Results Cysts of Giardia duodenalis (2.3%), ova of Ascaris lumbricoides (1.4%,), Trichuris trichiura (0.5%), and both A. lumbricoides and T. trichiura (0.9%) were identified in samples through wet mount preparation. The distribution of Cryptosporidium spp. as detected by the staining method and nested PCR was 1.4% and 4.1%, respectively. Conclusion Factors independently associated with Cryptosporidium infection are unsafe water, lack of regular hand washing, and insufficiency of exclusive breastfeeding. This study reports, presumably for the first time, the detection of Cryptosporidium oocysts in Chattogram metropolitan city of Bangladesh.
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Oyegue-Liabagui SL, Ndjangangoye NK, Kouna LC, Lekolo GM, Mounioko F, Kwedi Nolna S, Lekana-Douki JB. Molecular prevalence of intestinal parasites infections in children with diarrhea in Franceville, Southeast of Gabon. BMC Infect Dis 2020; 20:350. [PMID: 32414337 PMCID: PMC7226932 DOI: 10.1186/s12879-020-05071-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/04/2020] [Indexed: 01/30/2023] Open
Abstract
Background Pediatric diarrhea caused by a range of pathogens, including intestinal parasites, is one of main causes of death among children under 5 years of age. The distribution of these parasitic infections overlaps in many environmental, socioeconomic and epidemiological settings. Their distribution and prevalence varies from region to region. In the current study, we assess the prevalence of intestinal parasites among pediatric patients with syndromic diarrheal disease living in Franceville, Gabon. Methods A cross-sectional study conducted in the Amissa Bongo Regional Hospital and Chinese-Gabonese Friendship Hospital in Franceville, between November 2016 and August 2017, enrolled a total of 100 diarrheic children between 0 and 180 months of age. Parasite detection in stool samples was performed using molecular diagnostic by PCR. Difference in means were tested by Student’s t test and ANOVA while principal component analysis was used to determine the correlation between parasite distributions and age groups. Results The overall prevalence of intestinal parasite infection was 61% (61/100). Hymenolepis sp and Cryptosporidium hominis/parvum were the most common parasites (31 and 19%, respectively), followed by Encephalitozoon intestinalis (15%), Trichuris trichiura (4%), Dientamoeba fragilis (4%), and Enterocytozoon bieneusi (2%). The polyparasitism rate was 19.7%, with 83.3% double and 16.7% triple infections. Protozoan infections (66.7%) were more prevalent than helminths infections (33.3%). Seasonal association of the circulation of intestinal parasite was statistically significant (p = 0.03). Correlations between different parasites was also observed. Conclusion The prevalence of intestinal parasitic infections is highest in diarrheic pediatric children. The prevalence of parasitic infections indicates that protozoa and helminths are the most common parasites in the Franceville environment. This study reinforces the importance of routine examination of diarrheic stool samples for the diagnostic of intestinal parasites. Further analyses are required to better understand the local epidemiology and risk factors associated with the transmission of intestinal parasites in Franceville, Gabon. Keyswords diarrhea, children, intestinal parasitic infections, molecular diagnostic, Franceville, Gabon.
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Affiliation(s)
- Sandrine Lydie Oyegue-Liabagui
- Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale (ECODRAC), Université des Sciences et Techniques de Masuku, BP 876, Franceville, Gabon. .,Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon.
| | - Nal Kennedy Ndjangangoye
- Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale (ECODRAC), Université des Sciences et Techniques de Masuku, BP 876, Franceville, Gabon.,Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon
| | - Lady Charlene Kouna
- Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon
| | - Gwladys Mirlande Lekolo
- Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon
| | - Franck Mounioko
- Laboratoire d'Ecologie Vectoriel, Institut de Recherche en Ecologie Tropicale, BP 13354, Libreville, Gabon
| | - Sylvie Kwedi Nolna
- Capacity for Leadership Excellence And Research (CLEAR, Inc.), Yaoundé, Cameroon
| | - Jean Bernard Lekana-Douki
- Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon.,Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
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Bauhofer AFL, Cossa-Moiane I, Marques S, Guimarães EL, Munlela B, Anapakala E, Chilaúle JJ, Cassocera M, Langa JS, Chissaque A, Sambo J, Manhique-Coutinho L, Bero DM, Kellogg TA, de Deus N. Intestinal protozoan infections among children 0-168 months with diarrhea in Mozambique: June 2014 - January 2018. PLoS Negl Trop Dis 2020; 14:e0008195. [PMID: 32320399 PMCID: PMC7176080 DOI: 10.1371/journal.pntd.0008195] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 03/03/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Intestinal parasites such as Cryptosporidium spp., Giardia lamblia and Entamoeba histolytica can cause severe diarrhea, especially among children in developing countries. This study aims to determine the frequency of Cryptosporidium spp., Giardia lamblia and Entamoeba histolytica in children with diarrhea and identify risk factors for infection. METHODOLOGY We conducted a cross-sectional study in children aged 0-168 months hospitalized with diarrhea in three regions of Mozambique, from June 2014 to January 2018. Following consent, caretakers were interviewed and a single stool specimen was collected from each child to diagnose Cryptosporidium spp., G. lamblia and E. histolytica using commercial immune-enzymatic assay (TechLab, Inc, Blacksburg, VA, USA). Anthropometric data were collected from the clinical reports. Multivariable logistic regression models were built to identify risk factors for Cryptosporidium spp. and G. lamblia infection. RESULTS Twenty-one percent of all specimens (212/1008) presented at least one parasitic infection. Cryptosporidium spp. infection was the most common 12.0% (118/985), followed by G. lamblia 9.7% (95/983) and E. histolytica 2.0% (20/1004). Risk factors for infection by Cryptosporidium spp. were: provenience (children from Nampula province showed the highest risk, OR: 8.176; CI: 1.916-34.894; p-value < 0.01); animal contact (children with animal contact had a protective effect OR: 0.627; CI: 0.398-0.986; p-value < 0.05); underweight (children severely underweight showed a risk of 2.309; CI: 1.310-4.069; p-value < 0.05). Risk factors for infection by G. lamblia were: age (group with highest risk, 60-168 months (OR: 2.322; CI: 1.000-5.393, p-value > 0.05)); and living in a household with five or more members (OR: 2.141; CI: 1.286-3.565, p-value < 0.01). CONCLUSIONS Parasitic infection is common among children with diarrhea. Routine testing, standard treatment, and assessment for risk exposure of children with diarrhea should be implemented at health facilities in Mozambique.
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Affiliation(s)
- Adilson Fernando Loforte Bauhofer
- Direcção de Formação e Comunicação em Saúde, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisboa, Portugal
| | - Idalécia Cossa-Moiane
- Direcção de Laboratórios de Saúde Pública, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
- Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | - Selma Marques
- Direcção de Formação e Comunicação em Saúde, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
- Centro de Biotecnologia, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Esperança L. Guimarães
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisboa, Portugal
- Direcção de Pesquisa em Saúde e Bem-Estar, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
| | - Benilde Munlela
- Direcção de Formação e Comunicação em Saúde, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
- Centro de Biotecnologia, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Elda Anapakala
- Direcção de Laboratórios de Saúde Pública, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
| | - Jorfélia J. Chilaúle
- Direcção de Laboratórios de Saúde Pública, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
| | - Marta Cassocera
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisboa, Portugal
- Direcção de Pesquisa em Saúde e Bem-Estar, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
| | - Jerónimo S. Langa
- Direcção de Laboratórios de Saúde Pública, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
| | - Assucênio Chissaque
- Direcção de Formação e Comunicação em Saúde, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisboa, Portugal
| | - Júlia Sambo
- Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisboa, Portugal
- Direcção de Pesquisa em Saúde e Bem-Estar, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
| | - Lena Manhique-Coutinho
- Direcção de Laboratórios de Saúde Pública, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
| | - Diocreciano Matias Bero
- Direcção de Laboratórios de Saúde Pública, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
| | - Timothy A. Kellogg
- Direcção de Inquéritos e Observação de Saúde, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Nilsa de Deus
- Direcção de Pesquisa em Saúde e Bem-Estar, Instituto Nacional de Saúde (INS), Marracuene, Moçambique
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Gomez-Puerta LA, Gonzalez AE, Vargas-Calla A, Lopez-Urbina MT, Cama V, Xiao L. Cryptosporidium parvum as a risk factor of diarrhea occurrence in neonatal alpacas in Peru. Parasitol Res 2019; 119:243-248. [PMID: 31754858 DOI: 10.1007/s00436-019-06468-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/22/2019] [Indexed: 11/25/2022]
Abstract
Cryptosporidiosis has been reported as an important cause of neonatal diarrhea and mortality in cattle, sheep, and other ruminants, but its impact on alpaca health has not been studied thoroughly. In this study, we have determined the prevalence and evaluated the role of cryptosporidiosis as a risk factor for diarrhea occurrence in newborn alpacas. During the calving season (January-March) of 2006, stool specimens (N = 1312) were collected from 24 herds of newborn alpacas in Puno and Cuzco, departments that account for the largest populations of alpacas in Peru. All the specimens were microscopically screened for Cryptosporidium spp. using the acid-fast technique. The association between Cryptosporidium detection and diarrhea was analyzed using χ2 test and generalized lineal model. Cryptosporidium species were determined by PCR-RFLP analysis of the small subunit rRNA gene. Cryptosporidium oocysts were detected in 159 of 1312 (12.4%) newborn alpacas. Results of the analyses demonstrated that crypstosporidiosis was significantly associated with diarrhea (PR = 3.84; CI95% 2.54-5.81; p < 0.0001). Only Cryptosporidium parvum was detected in the 153 Cryptosporidium-infected animals. Thus, there is an association of C. parvum infection with diarrhea in neonatal alpacas.
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Affiliation(s)
- Luis A Gomez-Puerta
- Department of Veterinary Epidemiology and Economics, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Av. Circunvalacion 2800, San Borja, 41, Lima, Peru.
| | - Armando E Gonzalez
- Department of Veterinary Epidemiology and Economics, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Av. Circunvalacion 2800, San Borja, 41, Lima, Peru
| | - Ana Vargas-Calla
- Department of Veterinary Epidemiology and Economics, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Av. Circunvalacion 2800, San Borja, 41, Lima, Peru
| | - Maria T Lopez-Urbina
- Department of Veterinary Epidemiology and Economics, School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Av. Circunvalacion 2800, San Borja, 41, Lima, Peru
| | - Vitaliano Cama
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lihua Xiao
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China
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Miambo RD, Laitela B, Malatji MP, De Santana Afonso SM, Junior AP, Lindh J, Mukaratirwa S. Prevalence of Giardia and Cryptosporidium in young livestock and dogs in Magude District of Maputo Province, Mozambique. ACTA ACUST UNITED AC 2019; 86:e1-e6. [PMID: 31478737 PMCID: PMC6739555 DOI: 10.4102/ojvr.v86i1.1709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/04/2019] [Accepted: 02/11/2019] [Indexed: 11/01/2022]
Abstract
BACKGROUND Giardia and Cryptosporidium species are significant zoonotic parasites of humans and domesticated animals. OBJECTIVES The study aimed to determine the prevalence of Giardia and Cryptosporidium in livestock and dogs of the Magude District. METHOD The flotation technique (Willis), modified Ziehl-Neelsen (mZN) and direct and indirect immunofluorescence (DIF and IIF) techniques were applied to determine the prevalence of Giardia and Cryptosporidium species in faecal samples of dog pups (156), goat kids (60) and calves (480) from the Magude District of Mozambique from February to September 2015. RESULTS Using Willis, IIF and DIF, the prevalence of Giardia in calves was 0%, 8.1%, and 6.0%; in dogs 0.6%, 8.3% and 5.7% and for goats 0% and 13.3% (IIF was not performed), respectively. The prevalence of Cryptosporidium in calves using Willis, mZN, IIF and DIF was 0%, 3.8%, 4.7% and 0.4% and in dogs 0%, 0.6%, 6.4% and 0.6%, respectively. The parasite was not detected in goats. CONCLUSION Results from the present study showed that IIF performed better diagnosis of Giardia and Cryptosporidium, and that the mZN can be used as an alternative for Cryptosporidium because of the high cost of IIF. There is a need for identification of genotypes or subtypes of these parasites through application of molecular techniques in order to determine their zoonotic potential, and we advocate a 'one health' approach in the control and prevention of these parasites.
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Affiliation(s)
- Regina D Miambo
- Department of Para-Clinics, Faculty of Veterinary Medicine, Eduardo Mondlane University, Maputo, Mozambique; and, School of Life Science, College of Agriculture, Engineering and Science, University of KwaZulu-Natal, Westville, South Africa.
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Tosini F, Ludovisi A, Tonanzi D, Amati M, Cherchi S, Pozio E, Gómez-Morales MA. Delivery of SA35 and SA40 peptides in mice enhances humoral and cellular immune responses and confers protection against Cryptosporidium parvum infection. Parasit Vectors 2019; 12:233. [PMID: 31092283 PMCID: PMC6518611 DOI: 10.1186/s13071-019-3486-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/06/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cryptosporidium parvum is a major cause of diarrhea in children and ruminants at the earliest stages of life. Maternal antibodies represent the main shield of neonate mammals for most of the infections. Two recombinant antigens (SA35 and SA40), portions of two C. parvum proteins, were tested for their ability to induce immune responses in adult mice and for protection on neonate BALB/c mice born from females immunised by mucosal delivery of both peptides. METHODS Adult BALB/c mice were intraperitoneally immunised with SA35 and SA40, separately or mixed, and their immune response was characterised. Furthermore, BALB/c pregnant mice were immunised by mucosal delivery with an SA35/40 mix, before and during pregnancy. Soon after birth, their offspring were infected with two doses (1 × 105 and 5 × 103) of C. parvum oocysts and the parasitic burden was determined at 5 and 9 days post-infection. RESULTS Intraperitoneal immunisation with SA35 and SA40 induced specific IgG and IgG1 in serum, specific IgA in the intestinal mucosa, increase of CD3+/CD4+ and CD30+ cells in splenocytes, which produced IFN-γ. Neonates born from immunised mice and infected with 1 × 105 oocysts showed a significant reduction of oocysts and intestinal forms (23 and 42%, respectively). A reduction of all parasitic forms (96%; P < 0.05) was observed when neonates were infected with 5 × 103 oocysts. CONCLUSIONS SA35 and SA40 peptides induce specific humoral and cell-mediated immune responses to C. parvum in adult mice. Moreover, mucosal administration of the SA35/40 mix in pregnant mice reduces C. parvum burden in their litters.
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Affiliation(s)
- Fabio Tosini
- European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy
| | - Alessandra Ludovisi
- European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy
| | - Daniele Tonanzi
- European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Amati
- European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy
| | - Simona Cherchi
- European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy
| | - Edoardo Pozio
- European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy
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Bouzid M, Kintz E, Hunter PR. Risk factors for Cryptosporidium infection in low and middle income countries: A systematic review and meta-analysis. PLoS Negl Trop Dis 2018; 12:e0006553. [PMID: 29879110 PMCID: PMC6014672 DOI: 10.1371/journal.pntd.0006553] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/22/2018] [Accepted: 05/22/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Cryptosporidium infection causes gastrointestinal disease and has a worldwide distribution. The highest burden is in developing countries. OBJECTIVES We sought to conduct a systematic review and meta-analysis to identify Cryptosporidium risk factors in Low and Middle Income countries (LMICs). METHODS Medline Ovid and Scopus databases were searched with no restriction on year or language of publication. All references were screened independently in duplicate and were included if they presented data on at least 3 risk factors. Meta-analyses using random effects models were used to calculate overall estimates for each exposure. RESULTS The most frequently reported risk factors in the 15 included studies were overcrowding, household diarrhoea, poor quality drinking water, animal contact, open defecation/ lack of toilet and breastfeeding. The combined odds ratio for animal contact was 1.98 (95%CI: 1.11-3.54) based on 11 studies and for diarrhoea in the household 1.98 (95%CI: 1.13-3.49) based on 4 studies. Open defecation was associated with a pooled odds ratio of 1.82 (95%CI: 1.19-2.8) based on 5 studies. Poor drinking water quality was not associated with a significant Cryptosporidium risk, odds ratio 1.06 (95%CI: 0.77-1.47). Breastfeeding was protective with pooled odds ratio 0.4 (95%CI: 0.13-1.22), which was not statistically significant. CONCLUSIONS Based on the included studies, crowded living conditions, animal contact and open defecation are responsible for the majority of Cryptosporidium cases in LMICs. Future studies investigating Cryptosporidium risk factors should have a good study design and duration, include appropriate number of cases, select suitable controls, investigate multiple relevant risk factors, fully report data and perform multivariate analysis.
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Affiliation(s)
- Maha Bouzid
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- * E-mail:
| | - Erica Kintz
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of East Anglia, Norwich, United Kingdom
| | - Paul R. Hunter
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of East Anglia, Norwich, United Kingdom
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10
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Boughattas S, Behnke JM, Al-Ansari K, Sharma A, Abu-Alainin W, Al-Thani A, Abu-Madi MA. Molecular Analysis of the Enteric Protozoa Associated with Acute Diarrhea in Hospitalized Children. Front Cell Infect Microbiol 2017; 7:343. [PMID: 28824878 PMCID: PMC5539595 DOI: 10.3389/fcimb.2017.00343] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 07/14/2017] [Indexed: 12/16/2022] Open
Abstract
Pediatric diarrhea is a common cause of death among children under 5 years of age. In the current study, we investigated the frequency of intestinal parasites among 580 pediatric patients with chronic diarrhea. Parasitic protozoa (all species combined) were detected by molecular tools in 22.9% of the children and the most common parasite was Cryptosporidium spp. (15.1%). Blastocystis hominis was detected in 4.7%, Dientamoeba fragilis in 4%, Giardia duodenalis in 1.7%, and Entamoeba histolytica in 0.17%. Protozoan infections were observed among all regional groups, but prevalence was highest among Qatari subjects and during the winter season. Typing of Cryptosporidium spp. revealed a predominance of Cryptosporidium parvum in 92% of cases with mostly the IIdA20G1 subtype. Subtypes IIdA19G2, IIdA18G2, IIdA18G1, IIdA17G1, IIdA16G1, and IIdA14G1 were also detected. For Cryptosporidium hominis, IbA10G2 and IbA9G3 subtypes were identified. This study provides supplementary information for implementing prevention and control strategies to reduce the burden of these pediatric protozoan infections. Further analyses are required to better understand the local epidemiology and transmission of Cryptosporidium spp. in Qatar.
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Affiliation(s)
- Sonia Boughattas
- Department of Biomedical Science, College of Health Sciences, Biomedical Research Center, Qatar UniversityDoha, Qatar
| | - Jerzy M Behnke
- School of Life Sciences, University of Nottingham, University ParkNottingham, United Kingdom
| | - Khalid Al-Ansari
- Hamad Medical Corporation, Paediatric Emergency CenterDoha, Qatar
| | - Aarti Sharma
- Department of Biomedical Science, College of Health Sciences, Biomedical Research Center, Qatar UniversityDoha, Qatar
| | - Wafa Abu-Alainin
- Molecular Genetics Laboratory, Department of Laboratory Medicine and Pathology, Hamad Medical CorporationDoha, Qatar
| | - Asma Al-Thani
- Department of Biomedical Science, College of Health Sciences, Biomedical Research Center, Qatar UniversityDoha, Qatar
| | - Marawan A Abu-Madi
- Department of Biomedical Science, College of Health Sciences, Biomedical Research Center, Qatar UniversityDoha, Qatar
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11
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Squire SA, Ryan U. Cryptosporidium and Giardia in Africa: current and future challenges. Parasit Vectors 2017; 10:195. [PMID: 28427454 PMCID: PMC5397716 DOI: 10.1186/s13071-017-2111-y] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/24/2017] [Indexed: 12/15/2022] Open
Abstract
Cryptosporidium and Giardia are important causes of diarrhoeal illness. Adequate knowledge of the molecular diversity and geographical distribution of these parasites and the environmental and climatic variables that influence their prevalence is important for effective control of infection in at-risk populations, yet relatively little is known about the epidemiology of these parasites in Africa. Cryptosporidium is associated with moderate to severe diarrhoea and increased mortality in African countries and both parasites negatively affect child growth and development. Malnutrition and HIV status are also important contributors to the prevalence of Cryptosporidium and Giardia in African countries. Molecular typing of both parasites in humans, domestic animals and wildlife to date indicates a complex picture of both anthroponotic, zoonotic and spill-back transmission cycles that requires further investigation. For Cryptosporidium, the only available drug (nitazoxanide) is ineffective in HIV and malnourished individuals and therefore more effective drugs are a high priority. Several classes of drugs with good efficacy exist for Giardia, but dosing regimens are suboptimal and emerging resistance threatens clinical utility. Climate change and population growth are also predicted to increase both malnutrition and the prevalence of these parasites in water sources. Dedicated and co-ordinated commitments from African governments involving "One Health" initiatives with multidisciplinary teams of veterinarians, medical workers, relevant government authorities, and public health specialists working together are essential to control and prevent the burden of disease caused by these parasites.
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Affiliation(s)
- Sylvia Afriyie Squire
- School of Veterinary and Life Sciences, Murdoch University, Perth, Australia
- Council for Scientific and Industrial Research, Animal Research Institute, Accra, Ghana
| | - Una Ryan
- School of Veterinary and Life Sciences, Murdoch University, Perth, Australia
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12
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Yang Y, Zhou Y, Cheng W, Pan X, Xiao P, Shi Y, Gao J, Song X, Chen Y, Jiang Q. Prevalence and Determinants of Cryptosporidium Infection in an Underdeveloped Rural Region of Southwestern China. Am J Trop Med Hyg 2017; 96:595-601. [PMID: 28093538 PMCID: PMC5361533 DOI: 10.4269/ajtmh.16-0732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 11/30/2016] [Indexed: 01/08/2023] Open
Abstract
Few studies have focused on the epidemiology of Cryptosporidium in resource-challenged settings in China. We report a community-based cross-sectional study to investigate the prevalence of Cryptosporidium infection and its risk factors and associations with hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections. The prevalence of Cryptosporidium infection was 12.6% (95% confidence interval = 11.0-14.3). Individuals living in households with ≥ 5 family members and raising domestic pigs tended to have a greater risk of Cryptosporidium infection. In addition, Cryptosporidium infection was significantly associated with HBV infection. There were no significant associations of Cryptosporidium infection with HIV viral load and HBV viral load. Further studies are needed to determine the association of Cryptosporidium infection with HBV infection.
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Affiliation(s)
- Ya Yang
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Yibiao Zhou
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Wanting Cheng
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Xiang Pan
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Penglei Xiao
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Yan Shi
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Jianchuan Gao
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Xiuxia Song
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Yue Chen
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Qingwu Jiang
- School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
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Oriá RB, Murray-Kolb LE, Scharf RJ, Pendergast LL, Lang DR, Kolling GL, Guerrant RL. Early-life enteric infections: relation between chronic systemic inflammation and poor cognition in children. Nutr Rev 2016; 74:374-86. [PMID: 27142301 DOI: 10.1093/nutrit/nuw008] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The intestinal microbiota undergoes active remodeling in the first 6 to 18 months of life, during which time the characteristics of the adult microbiota are developed. This process is strongly influenced by the early diet and enteric pathogens. Enteric infections and malnutrition early in life may favor microbiota dysbiosis and small intestinal bacterial overgrowth, resulting in intestinal barrier dysfunction and translocation of intestinal bacterial products, ultimately leading to low-grade, chronic, subclinical systemic inflammation. The leaky gut-derived low-grade systemic inflammation may have profound consequences on the gut-liver-brain axis, compromising normal growth, metabolism, and cognitive development. This review examines recent data suggesting that early-life enteric infections that lead to intestinal barrier disruption may shift the intestinal microbiota toward chronic systemic inflammation and subsequent impaired cognitive development.
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Affiliation(s)
- Reinaldo B Oriá
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA.
| | - Laura E Murray-Kolb
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Rebecca J Scharf
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Laura L Pendergast
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Dennis R Lang
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Glynis L Kolling
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Richard L Guerrant
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
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Tellevik MG, Moyo SJ, Blomberg B, Hjøllo T, Maselle SY, Langeland N, Hanevik K. Prevalence of Cryptosporidium parvum/hominis, Entamoeba histolytica and Giardia lamblia among Young Children with and without Diarrhea in Dar es Salaam, Tanzania. PLoS Negl Trop Dis 2015; 9:e0004125. [PMID: 26452235 PMCID: PMC4599730 DOI: 10.1371/journal.pntd.0004125] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/07/2015] [Indexed: 11/18/2022] Open
Abstract
Background Although enteroparasites are common causes of diarrheal illness, few studies have been performed among children in Tanzania. This study aimed to investigate the prevalence of Cryptosporidium parvum/hominis, Entamoeba histolytica and Giardia lamblia among young children in Dar es Salaam, Tanzania, and identify risk factors for infection. Methodology/Principal Findings We performed an unmatched case-control study among children < 2 years of age in Dar es Salaam, recruited from August 2010 to July 2011. Detection and identification of protozoans were done by PCR techniques on DNA from stool specimens from 701 cases of children admitted due to diarrhea at the three study hospitals, and 558 controls of children with no history of diarrhea during the last month prior to enrollment. The prevalence of C. parvum/hominis was 10.4% (84.7% C. hominis), and that of G. lamblia 4.6%. E. histolytica was not detected. The prevalence of Cryptosporidium was significantly higher in cases (16.3%) than in controls (3.1%; P < 0.001; OR = 6.2; 95% CI: 3.7–10.4). G. lamblia was significantly more prevalent in controls (6.1%) than in cases (3.4%; P = 0.027; OR = 1.8; 95% CI: 1.1–3.1). Cryptosporidium infection was found more often in HIV-positive (24.2%) than in HIV-negative children (3.9%; P < 0.001; OR = 7.9; 95% CI: 3.1–20.5), and was also associated with rainfall (P < 0.001; OR = 2.41; 95% CI: 1.5–3.8). Among cases, stunted children had significantly higher risk of being infected with Cryptosporidium (P = 0.011; OR = 2.12; 95% CI: 1.2–3.8). G. lamblia infection was more prevalent in the cool season (P = 0.004; OR = 2.2; 95% CI: 1.3–3.8), and more frequent among cases aged > 12 months (P = 0.003; OR = 3.5; 95% CI: 1.5–7.8). Among children aged 7–12 months, those who were breastfed had lower prevalence of G. lamblia infection than those who had been weaned (P = 0.012). Conclusions Cryptosporidium infection is common among young Tanzanian children with diarrhea, particularly those living with HIV, and infection is more frequent during the rainy season. G. lamblia is frequently implicated in asymptomatic infections, but rarely causes overt diarrheal illness, and its prevalence increases with age. Diarrheal diseases are a leading cause of disease and deaths among young children. In Africa they contribute to more than one tenth of childhood deaths. Parasites like Cryptosporidium, Entamoeba histolytica and Giardia lamblia are all common causes of diarrheal illness, but there are few studies on these enteroparasites among Tanzanian children. In this case-control study, we included 701 cases and 558 controls, all < 2 years of age, in Dar es Salaam, Tanzania. We assessed the prevalence of C. parvum/hominis, E. histolytica and G. lamblia by PCR, and the association with potential risk factors such as demographic data, clinical symptoms, HIV status and seasonality. One or more parasites were found in 14.9% of the samples. C. parvum/ hominis and G. lamblia were found in 10.4% and 4.6%, respectively, while E. histolytica was not found in any of the samples. The prevalence of Cryptosporidium was high, particularly in children with HIV, and its prevalence increased during the rainy season. Among cases, Cryptosporidium was found more frequently in stunted children, although any causal association could not be established in the current study. G. lamblia was more often implicated in asymptomatic infections than in overt diarrheal illness. The prevalence of G. lamblia increased with age, and breastfeeding seemed to protect the children from G. lamblia. This study presents relevant information about the prevalence and clinical characteristics of these intestinal parasites in Tanzanian children.
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Affiliation(s)
- Marit G. Tellevik
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- * E-mail:
| | - Sabrina J. Moyo
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bjørn Blomberg
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Torunn Hjøllo
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Samuel Y. Maselle
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Kurt Hanevik
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
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15
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Brown J, Cumming O, Bartram J, Cairncross S, Ensink J, Holcomb D, Knee J, Kolsky P, Liang K, Liang S, Nala R, Norman G, Rheingans R, Stewart J, Zavale O, Zuin V, Schmidt WP. A controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children: research protocol for the Maputo Sanitation (MapSan) study, Mozambique. BMJ Open 2015; 5:e008215. [PMID: 26088809 PMCID: PMC4480002 DOI: 10.1136/bmjopen-2015-008215] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Access to safe sanitation in low-income, informal settlements of Sub-Saharan Africa has not significantly improved since 1990. The combination of a high faecal-related disease burden and inadequate infrastructure suggests that investment in expanding sanitation access in densely populated urban slums can yield important public health gains. No rigorous, controlled intervention studies have evaluated the health effects of decentralised (non-sewerage) sanitation in an informal urban setting, despite the role that such technologies will likely play in scaling up access. METHODS AND ANALYSIS We have designed a controlled, before-and-after (CBA) trial to estimate the health impacts of an urban sanitation intervention in informal neighbourhoods of Maputo, Mozambique, including an assessment of whether exposures and health outcomes vary by localised population density. The intervention consists of private pour-flush latrines (to septic tank) shared by multiple households in compounds or household clusters. We will measure objective health outcomes in approximately 760 children (380 children with household access to interventions, 380 matched controls using existing shared private latrines in poor sanitary conditions), at 2 time points: immediately before the intervention and at follow-up after 12 months. The primary outcome is combined prevalence of selected enteric infections among children under 5 years of age. Secondary outcome measures include soil-transmitted helminth (STH) reinfection in children following baseline deworming and prevalence of reported diarrhoeal disease. We will use exposure assessment, faecal source tracking, and microbial transmission modelling to examine whether and how routes of exposure for diarrhoeagenic pathogens and STHs change following introduction of effective sanitation. ETHICS Study protocols have been reviewed and approved by human subjects review boards at the London School of Hygiene and Tropical Medicine, the Georgia Institute of Technology, the University of North Carolina at Chapel Hill, and the Ministry of Health, Republic of Mozambique. TRIAL REGISTRATION NUMBER NCT02362932.
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Affiliation(s)
- Joe Brown
- School of Civil & Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Oliver Cumming
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Jamie Bartram
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sandy Cairncross
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Jeroen Ensink
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - David Holcomb
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jackie Knee
- School of Civil & Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Peter Kolsky
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kaida Liang
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Song Liang
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, USA
| | - Rassul Nala
- Ministry of Health, Republic of Mozambique, Maputo, Mozambique
| | - Guy Norman
- Water and Sanitation for the Urban Poor, London, UK
| | - Richard Rheingans
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, USA
| | - Jill Stewart
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Valentina Zuin
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Palo Alto, California, USA
| | - Wolf-Peter Schmidt
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
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16
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Pavlinac PB, Tickell KD, Walson JL. Management of diarrhea in HIV-affected infants and children. Expert Rev Anti Infect Ther 2014; 13:5-8. [PMID: 25384353 DOI: 10.1586/14787210.2015.981157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Globally, diarrhea is the second leading cause of death in children less than 5 years of age. HIV-infected and HIV-exposed uninfected (HEU) children are at high risk of dying from diarrhea and may be more susceptible to the highest risk enteric pathogens. This increased risk associated with HIV infection and HIV exposure is likely multifactorial. Factors such as immunosuppression, proximity to individuals more likely to be shedding pathogens, and exposure to antimicrobial prophylaxis may alter the risk profile in these children. Current international guidelines do not differentiate management strategies on the basis of whether children are infected or affected by HIV, despite likely differences in etiologies and consequences. Reducing diarrhea mortality in high HIV prevalence settings will require strengthening of HIV testing and treatment programs; improvements in water, sanitation and hygiene interventions targeted at HIV-affected households; and reconsideration of the use of empiric antimicrobial treatment of pathogens known to infect HIV-infected and HEU children disproportionately.
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Affiliation(s)
- Patricia B Pavlinac
- University of Washington, Global Health, 325 Ninth Avenue, Box 359931, Seattle, WA 98104, USA
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