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 ...