Cryptosporidium Sp. Findings and Its Symptomatology among Immunocompromised Patients

Abstract

BACKGROUND: Cryptosporidium sp. is an apicomplexan protozoa, and it is related to an immunocompromised state. As it develops diverse clinical manifestations, mild to life-threatening conditions, administration of anti-parasitic medication and its management remain problematic.
 AIM: The study aimed to provide Cryptosporidiosis symptomatology and its prevalence among HIV-infected patients in a tertiary referral hospital, Haji Adam Malik General Hospital, Medan, Indonesia.
 MATERIAL AND METHODS: Symptomatology was noted using short-questionnaire, and laboratory findings were obtained from the hospital medical record registry on the same day of admission. We enrolled 24 patients were suffered from HIV infection for a certain period and more than one-week diarrhoea including 18 males and 6 females. Routine faeces examination using wet mount, Kinyoun-gabet, and trichrome staining was performed for all samples in Parasitology Department, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. Numerical data were evaluated using the Mann-Whitney test while Fisher Exact test was used to determine any association between categorical variables.
 RESULTS: Our study found that 8 of 24 patients were positive with Cryptosporidium sp. while its symptomatology including abdominal cramp (66.7%), nausea and vomiting (70.8%), and fever (62.5%) is prevalent from our study. We obtained significant association between CD4 cell count (p = 0.006), diarrhea duration (p = 0.007), abdominal pain (p = 0.005), and nausea and vomiting (p = 0.021) with cryptosporidiosis.
 CONCLUSION: High consideration of several symptoms related to cryptosporidiosis leads a clinician to initiate prompt management particularly in a high-risk population.

First Molecular Characterization of Cryptosporidium spp. in Patients Living with HIV in Honduras

“…was investigated in a population of HIV-positive adults and a prevalence of 3.92% (4/102) was found. Several studies have aimed to estimate the prevalence of cryptosporidiosis in immunocompromised populations in different countries [ 5 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]; however, the results are heterogeneous even with data collected within the same country [ 7 , 37 , 38 ]. The discrepancies between the studies could be attributed in part to their methodological design; however, all the components of the epidemiological triad, which includes the interaction between the host, the parasite and the environment, could be behind these inconsistencies.…”

“…Conversely, in immunocompromised people, it causes severe diarrhea, fever, nausea, vomiting and dehydration that can lead to the death of the patient. The infection can also progress to chronic diarrhea [5], which can persist for several months in patients with CD4 counts below 50-100 cells/mm 3 [6,7]. These infections pose an additional challenge for the clinician and the patient because treatment in PLHIV has low efficacy.…”

The prevalence of Cryptosporidium spp. and other intestinal parasites in elderly patients

“…Power analysis was used to determine the size of the study. Considering the statistical parameters in the reference studies 9 , it was planned to recruit a total of 78 individuals, 39 for each group, with a test power of 0.80, α:0.05 first type error level and β: 0.20 second type error level.…”

“…causes chronic diarrhea in patients with immune deficiency and is generally not severe in people with normal immunity 16 . Symptoms of immune-compromised patients, are mainly nausea, vomiting, abdominal cramps, fever, and watery diarrhea 17,9 . In this study, 70.3% (n = 26) of patients who presented to the clinic had diarrhea.…”

Avances en el desarrollo de una vacuna efectiva contra Cryptosporidium parvum: una revisión de la literatura

“…A pesar de los recientes avances para el manejo de infecciones de interés médico, no existe una terapia efectiva para el control de Crypstosporidium spp. en población vulnerable ( 23), por lo cual, esta infección puede ocasionar complicaciones médicas dadas por la deshidratación, alteración del estado de conciencia, retraso en el desarrollo global y, en algunos casos, la muerte del paciente (24,25). Teniendo en cuenta la problemática que representa la propagación de C. En otro estudio, se administraron 2 antígenos en ratones, Cp15 y profilina de Cryptosporidium, en un régimen heterólogo de refuerzo primario como fusiones con citolisina A (ClyA) en un vector de vacuna viva de Salmonella; a partir de allí, se encontró que estos antígenos fueron potentes en la inducción de respuestas inmunes humorales y celulares (41).…”