Cryptosporidiosis in Indonesia: a hospital-based study and a community-based survey.

Abstract

Abstract. Hospital-based and community-based studies were conducted to understand the prevalence and mode of transmission of Cryptosporidium parvum infection in Surabaya, Indonesia. In both studies people with and without diarrhea were examined for oocysts. A community-based survey included questionnaires to a community and stool examination of cats. Questionnaires covered demographic information, health status, and hygienic indicators. In the hospital, C. parvum oocysts were found in 26 (2.8%) of 917 patients with diarrhea and 15 (1.4%) of 1,043 control patients. The most susceptible age was less than two years old. The prevalence was higher during the rainy season. A community-based study again showed that C. parvum oocysts were frequently detected in diarrhea samples (8.2%), exclusively during rainy season. Thirteen (2.4%) of 532 cats passed C. parvum oocysts. A multiple logistic regression model indicated that contact with cats, rain, flood, and crowded living conditions are significant risk factors for Cryptosporidium infection.The protozoan Cryptosporidium parvum is now recognized as an important cause of diarrhea in both immunocompetent and immunosuppressed patients. A number of surveys carried out in recent years have described the worldwide distribution of Cryptosporidium. [1][2][3][4][5][6][7][8][9][10] The prevalence of Cryptosporidium infection is higher among children than among adults and is more common in developing countries than in developed countries. 1-10 Infection occurs by ingestion of oocysts either through human-to-human or animal-to-human contact, or via contaminated water. 5,6,[11][12][13][14][15][16] Despite its wide distribution and obvious relevance to public health, Cryptosporidium remains a little-studied protozoan in Indonesia. The present studies were undertaken to 1) assess the importance of Cryptosporidium in the causation of acute diarrhea among patients of all age groups who visited a hospital, and 2) understand the community prevalence and the mode of transmission of Cryptosporidium infection in Surabaya, Indonesia. MATERIALS AND METHODSStudy population and sample collection. Hospital-based study. Observations were made over a period of one year from August 1992 to July 1993 at the Dr. Soetomo Hospital, which is part of the University of Airlanaga in Surabaya. The hospital has 1,466 beds. During the study period, 92,061 patients visited the hospital and 41,622 patients were admitted. At total of 3,892 of 41,622 in-patients and 1,982 of 50,439 out-patients had diarrhea. The study population consisted of 917 patients with acute diarrhea: 715 in-patients and 202 out-patients. A group of 1,043 in-patients selected during the study period served as controls; none of these patients had any gastrointestinal problems. A stool specimen was collected from each patient within 24 hr of visiting the hospital.Community-based study. The studies were conducted in eight communities in Surabaya during the rainy season (December 1992 to March 1993) and dry season (June to July 1993). The total ...

Intra-familial and extra-familial risk factors associated with Cryptosporidium parvum infection among children hospitalized for diarrhea in Goiânia, Goiás, Brazil.

“…3,6,8,10,29 Our study similarly found a significant association between the odds of C. parvum infection and the occurrence of rain (Figure 1). Similar trends were also observed in other regions of Brazil, and in Indonesia and Zambia.…”

“…Similar trends were also observed in other regions of Brazil, and in Indonesia and Zambia. 3,6,10,29 The biologic source(s) for C. parvum infection and the exact routes of transmission during these wetter months have not been well described, but the impact of rainfall has been shown to mobilize and transport C. parvum oocysts out of fresh fecal material and fecal slurries and across vegetated soil surfaces and through soil columns. [30][31][32][33] Increased numbers of cases of C. parvum infection in Fortaleza and Lusaka during the rainy season were associated with contaminated drinking water supplied to these population, 3,6 but source of drinking water and mode of water disinfection were not associated with the odds of C. parvum infection among our study population.…”

Prevalence and Determinants of Cryptosporidium Infection in an Underdeveloped Rural Region of Southwestern China

“…This might be related to the crowded conditions in a household, which may translate into more frequent human-to-human contact, especially with children diarrhea, thus increasing the risk of Cryptosporidium transmission within families. [28][29][30] It was previously found that residents who raised livestock or poultry were more likely to be infected with Cryptosporidium in this area, supporting the hypothesis of zoonotic transmission of domestic animals. Domestic pigs in this region were mostly free ranging and tended to be around the residences.…”

Factors determining vulnerability to diarrhoea during and after severe floods in Bangladesh

“…In low-income countries, where the water supply and sanitation system and the causative agents of diarrhoea are likely to be different from those in high-income countries, post-flood increases in cholera (Sur et al 2000), rotavirus diarrhoea (Ahmed et al 1991;Fun et al 1991), cryptosporidiosis (Katsumata et al 1998) and non-specific diarrhoea (Woodruff et al 1990;Siddique et al 1991;Biswas et al 1999;Mondal et al 2001;Kondo et al 2002;Kunii et al 2002) have been reported. Most of these studies had methodological limitations, in particular lack of pre-flood data, lack of comparison groups and potential recall bias.…”