Cryptosporidium and Diarrhoea in Southern Indian Children

Mathan, M.; George, Renu; Venkatesan, S.; Mathew, Mary; Mathan, V. I.

doi:10.1016/s0140-6736(85)92691-1

Cited by 87 publications

(50 citation statements)

References 11 publications

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“…15 The relatively high percentage of asymptomatic infections detected in our study is consistent with earlier studies from developing countries. 16,17 We believe that the infection rate observed in the present study would have been even higher if more than one stool specimen had been collected from each child, especially in those who were symptomatic, because of the intermittent nature of oocyst excretion of this parasite. 18 Some patients excrete few oocysts, and cases may be missed if a sensitive method is not used.…”

Section: Discussionmentioning

confidence: 65%

Cryptosporidium infection in young children with diarrhea in Rawalpindi, Pakistan.

Iqbal

Munir²,

Khan³

1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. Fecal excretion of Cryptosporidium parvum oocysts was determined in 625 children less than five years old who presented at the pediatric clinic of a teaching hospital in Rawalpindi, Pakistan. Single stool specimens were collected from 475 children with acute diarrhea and from 150 children without diarrhea. The Cryptosporidium infection rate was significantly higher in children with diarrhea than in children without diarrhea (10.3% versus 3.3%). The C. parvum infection rate was highest in children 19-24 months of age (21.8%). There was no significant difference in the Cryptosporidium infection rate among male and female children of any age group studied. Sociodemographic information, drinking water supply, and contact with domestic animals had no significant role in the acquisition of C. parvum infection in our study population. The data suggest that C. parvum is relatively endemic in young children in the Rawalpindi area and that C. parvum may be an important pathogen associated with diarrhea.Enteric cryptosporidiosis is prevalent worldwide and causes a variety of problems ranging from acute severe diarrhea to self-limiting diarrhea, mainly in infants and young children, to nosocomial infection leading to fatal cases in immunocompromised persons. [1][2][3] In well-nourished, immunocompetent children, the disease is often short and selflimited. 2 However, this enteric agent is associated with persistent diarrhea in malnourished pediatric 4,5 and with prolonged severe or fatal watery diarrhea in patients with acquired immunodeficiency syndrome. 6 Children may be most susceptible, 4,7 and those less than two years old may have the greatest prevalence. 8 Epidemiologic studies have demonstrated that Cryptosporidium is more prevalent in developing countries (5% to Ͼ 10%) than in developed countries (Ͻ 1% to 3%). 2,3,[9][10][11] In most studies, the isolation rates from healthy persons have been low; however, several recent reports have identified high percentages of asymptomatic infections in children from South Africa 10 and India. 11 In Pakistan, no study has been conducted to determine the C. parvum infection rate in children. In this study, we report the prevalence and importance of C. parvum infection as a causal agent of acute diarrhea among children in Rawalpindi, Pakistan. MATERIALS AND METHODSStudy population. The study was conducted during the period March 1996 to September 1996 in 475 children (250 boys and 225 girls) less than three years of age with acute diarrheal disease presenting at the pediatric clinic of Rawalpindi General Teaching Hospital (RGH). The control group included 150 comparable children presenting at the same clinic with complaints other than gastrointestinal symptoms. This hospital covers a large area of population living in urban as well as in the rural areas. Four hundred twenty-two of the children were severely dehydrated and required admission to the hospital for rehydration. This extremely high rate of dehydration seen in the children is primarily due to the lack of health...

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Section: Discussionmentioning

confidence: 65%

Cryptosporidium infection in young children with diarrhea in Rawalpindi, Pakistan.

Iqbal

Munir²,

Khan³

1999

The American Journal of Tropical Medicine and Hygiene

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“…18,19 Reported prevalences of Cryptosporidium infection in Asia range from 3.6% in China, 20 4.3% in Bangladesh, 21 13.1% in India, 22 and 3.2% in Thailand. 23 The infection rate observed in the present study is lower than those reported elsewhere.…”

Section: Discussionmentioning

confidence: 99%

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

Katsumata¹,

Hosea²,

Wasito³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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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 ...

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“…7 In India, several studies have reported Cryptosporidium spp. in children with diarrhea (ranging from 1.3% to 18.9%) and in asymptomatic children (0-3%), [8][9][10][11][12] and one study reported up to 9.8% 13 positivity in asymptomatic children (with 13.1% positivity in symptomatic children).…”

Section: Introductionmentioning

confidence: 99%

Symptomatic and Asymptomatic Cryptosporidium Infections in Children in a Semi-Urban Slum Community in Southern India

Ajjampur¹,

Sarkar²,

Sankaran³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Cryptosporidium is a leading cause of childhood diarrhea in developing countries. We investigated symptomatic and asymptomatic cryptosporidiosis in 20 children less than two years of age in a semi-urban slum in southern India. All surveillance (conducted every two weeks) and diarrheal samples from 20 children (n = 1,036) with cryptosporidial diarrhea previously identified by stool microscopy were tested by polymerase chain reaction–restriction fragment length polymorphism for species and subgenotype determination. Thirty-five episodes of cryptosporidiosis were identified in 20 children, of which 25 were diarrheal. Fifteen episodes were associated with prolonged oocyst shedding. Multiple episodes of cryptosporidiosis occurred in 40% of the children. Most infections were with C. hominis, subtype Ia. Children with multiple infections had significantly lower weight-for-age and height-for-age Z scores at 24 months but had scores comparable with children with a single episode by 36 months. Multiple symptomatic Cryptosporidium infections associated with prolonged oocyst shedding occur frequently in this disease-endemic area and may contribute to the long-term effects of cryptosporidiosis on physical growth in these children.

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Cryptosporidium and Diarrhoea in Southern Indian Children

Cited by 87 publications

References 11 publications

Cryptosporidium infection in young children with diarrhea in Rawalpindi, Pakistan.

Cryptosporidium infection in young children with diarrhea in Rawalpindi, Pakistan.

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

Symptomatic and Asymptomatic Cryptosporidium Infections in Children in a Semi-Urban Slum Community in Southern India

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