Cryptosporidium, Enterocytozoon, and Cyclospora Infections in Pediatric and Adult Patients with Diarrhea in Tanzania

Cegielski, J. Peter; Ortega, Ynés R.; McKee, Steven; Madden, John F.; Gaido, Loretta; Schwartz, David A.; Manji, Karim; Jørgensen, Anja; Miller, SE; Pulipaka, U P; Msengi, A; Mwakyusa, D; Sterling, Charles R.; Reller, L. Barth

doi:10.1086/515131

Cited by 102 publications

(84 citation statements)

References 2 publications

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“…These results suggest that in Niger, the transmission of microsporidiosis could occur through person-to-person contact. This mode of transmission could be facilitated by enteric carriage of E. bieneusi, as described in previous studies (4,5). Nevertheless, taking into consideration the relatively small numbers of genotypes recovered from both areas, we must handle these preliminary results with care.…”

Section: Discussionmentioning

confidence: 78%

Molecular Study of Microsporidiosis Due toEnterocytozoon bieneusiandEncephalitozoon intestinalisamong Human Immunodeficiency Virus-Infected Patients from Two Geographical Areas: Niamey, Niger, and Hanoi, Vietnam

et al. 2007

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Microsporidiosis cases due to Enterocytozoon bieneusi and Encephalitozoon intestinalis are emerging opportunistic infections associated with a wide range of clinical syndromes in humans. The aim of this study was to specify microsporidial epidemiology in two different geographical areas. From November 2004 to August 2005, 228 and 42 stool samples were collected in Niamey, Niger, and Hanoi, Vietnam, respectively. Screening for microsporidia was performed using UV-light microscopy. Detection was confirmed by molecular biology using two methods specific for E. bieneusi and E. intestinalis. All samples positive for E. bieneusi were subjected to genotyping. In this study, we found high prevalences of microsporidiosis among human immunodeficiency virus-infected patients, 10.5% and 9.5%, respectively, in Niamey and Hanoi. These levels of prevalence are similar to those recorded in European countries before highly active antiretroviral therapy was introduced. In the samples positive for E. bieneusi, we found seven distinct genotypes, including two genotypes not previously described. The E. bieneusi genotype distributions in the two geographical areas suggest different routes of infection transmission, person-to-person in Niger and zoonotic in Vietnam.

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Section: Discussionmentioning

confidence: 78%

Molecular Study of Microsporidiosis Due toEnterocytozoon bieneusiandEncephalitozoon intestinalisamong Human Immunodeficiency Virus-Infected Patients from Two Geographical Areas: Niamey, Niger, and Hanoi, Vietnam

et al. 2007

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“…[3][4][5][6] Limited information is available on the infection in patients infected with the human immunodeficiency virus; infection rates of 0.1% in developed countries 7 and less than 1% to 11% in developing countries have been reported. 1,8,9 The low rates of infection in industrialized and some developing countries have been related to the common use of trimethoprim-sulfamethoxazole (TMP-SMX) for prophylaxis against opportunistic infections in these patients. 1,9 In Venezuela, the extent of the infection and its effects on human health is unknown.…”

Section: Introductionmentioning

confidence: 99%

“…1,8,9 The low rates of infection in industrialized and some developing countries have been related to the common use of trimethoprim-sulfamethoxazole (TMP-SMX) for prophylaxis against opportunistic infections in these patients. 1,9 In Venezuela, the extent of the infection and its effects on human health is unknown. There is no information on the occurrence of Cyclospora among immunocompromised or immunocompetent diarrheal individuals.…”

Section: Introductionmentioning

confidence: 99%

Cyclospora cayetanensis infections among diarrheal patients from Venezuela.

Chacín-Bonilla

Estévez²,

Monsalve³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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Abstract. The prevalence and importance of Cyclospora cayetanensis as an enteropathogen among 71 patients (22-45 years old) with acquired immunodeficiency syndrome (AIDS) and 132 children with diarrhea (0-12 years old) from Venezuela was assessed retrospectively. Two to three stool samples from each patient attending our parasitology laboratory for parasitologic and medical assistance were examined. For identification of the coccidium, modified Ziehl-Neelsen carbolfuchsin staining of formalin-ether stool concentrates was used, and for other intestinal parasites, iron-hematoxylin-stained smears and formalin-ether concentrates were examined. Cyclospora oocysts were found in seven (9.8%) of 71 AIDS patients and seven (5.3%) of 132 children with diarrhea. Other pathogenic parasites were present in most of the patients (9 of 14, 64.3%) shedding oocysts. Cyclosporiasis predominated in children 2-5 years of age with respect to those Յ one year of age (P Ͻ 0.05). The findings suggest that C. cayetanensis is common in diarrheal patients from Venezuela. However, the role of the parasite as the causal agent of diarrhea in these patients is uncertain.

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“…Human microsporidiosis has been reported predominantly from developed nations in North America, Europe, and Australia, but cases are now increasingly identified in the developing countries as well, and human infections with microsporidia have been reported from several African nations (2,4,6,7,11,12,14,22), Southeast Asia (15), and Central and South America (3,8,24,25). Although reliable estimates of the prevalence of microsporidiosis in developing countries are not available, some studies seem to indicate that the prevalence of intestinal microsporidiosis may be high in developing countries (10,22).…”

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confidence: 99%

“…Most cases of human microsporidiosis are associated with immunosuppression, but increasing numbers of cases in non-HIV-infected immunocompetent patients are reported. These reports include infections of travelers to developing countries as well as infections of residents of various tropical countries (1,5,6,11,13,14,17,(19)(20)(21)23). Only a few studies examined the role of microsporidia in returning travelers.…”

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confidence: 99%

Detection of Microsporidia in Travelers with Diarrhea

et al. 2001

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We examined stool specimens of 148 returning travelers from an outpatient department for tropical diseases for the appearence of microsporidia using light microscopy and PCR. Intestinal microsporidiosis was diagnosed for five patients by light microscopy and for nine patients by PCR. Some cases were diagnosed only by PCR, indicating that the true prevalence has to be determined by highly sensitive techniques, such as PCR.Diarrhea affects 20 to 70% of travelers in tropical or subtropical countries. Typically, self-limiting travelers' diarrhea is more of an inconvenience than a life-threatening disease. In general, bacteria, e.g., Escherichia coli, are the most common pathogens isolated in travelers' diarrhea. However, different intestinal protozoan parasites are recognized in travelers with diarrhea as well. Microsporidia are important protozoan parasites in human immunodeficiency virus (HIV)-infected patients. Limited data are available about microsporidian infections in immunocompetent patients and travelers (1,17,19,21).Stool samples were obtained from 148 travelers with diarrhea returning from different tropical areas between January and March 1998. Stool samples were examined by light microscopy (Uvitex 2B staining) and PCR as previously described (16). PCR products were digested with the restriction endonucleases PstI (20 U) and HaeIII (10 U) (Sigma) in a final volume of 15 l, producing distinctive fragments. The 250-bp DNA fragment of Enterocytozoon bieneusi was not cut by PstI and produced a 208-bp DNA fragment after digestion with HaeIII. The 268-bp DNA fragment of Encephalitozoon cuniculi was cut by PstI into two, 122-and 146-bp DNA fragments and by HaeIII into a 189-bp DNA fragment. The 270-bp DNA fragment of Encephalitozoon intestinalis was cut by PstI into two, 124-and 146-bp DNA fragments and by HaeIII into a 193-bp DNA fragment. The 279-bp DNA fragment of Encephalitozoon hellem was cut by PstI into two, 133-and 146-bp DNA fragments and by HaeIII into a 200-bp DNA fragment (9). Purified DNA fragments were ligated into a pGEM-T vector (Promega). Plasmids were transfected in competent E. coli cells (JM109) and plated on ampicillin-isopropyl-␤-D-thiogalactopyranoside-S-bromo-4-chloro-3-indolyl-␤-D-galactopyranoside agar plates for blue-white screening. White colonies were selected, and plasmids were isolated from the cells by using the High Pure plasmid isolation kit (Boehringer, Mannheim, Germany). Both DNA strands of the cloned DNA fragments were sequenced on an automated DNA sequencer (ABI Prism 377 DNA Sequencer; Applied Biosystems) using the Taq FS BigDye-terminator cycle sequencing method starting with two vector-directed primers (T7 primer [5Ј-TAATACGACTC ACTATAGGG-3Ј] and M-13 reverse primer [5Ј-TTCACACA GGAAACAGCTATGACG-3Ј]) flanking the cloned DNA fragments.

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Cryptosporidium, Enterocytozoon, and Cyclospora Infections in Pediatric and Adult Patients with Diarrhea in Tanzania

Cited by 102 publications

References 2 publications

Molecular Study of Microsporidiosis Due toEnterocytozoon bieneusiandEncephalitozoon intestinalisamong Human Immunodeficiency Virus-Infected Patients from Two Geographical Areas: Niamey, Niger, and Hanoi, Vietnam

Molecular Study of Microsporidiosis Due toEnterocytozoon bieneusiandEncephalitozoon intestinalisamong Human Immunodeficiency Virus-Infected Patients from Two Geographical Areas: Niamey, Niger, and Hanoi, Vietnam

Cyclospora cayetanensis infections among diarrheal patients from Venezuela.

Detection of Microsporidia in Travelers with Diarrhea

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