The Gut-Wrenching Effects of Cryptosporidiosis and Giardiasis in Children

Abstract

Cryptosporidium species and Giardia duodenalis are infectious intestinal protozoan pathogens that cause alarming rates of morbidity and mortality worldwide. Children are more likely to have clinical symptoms due to their less developed immune systems and factors such as undernutrition, especially in low- and middle-income countries. The severity of the symptoms and clinical manifestations in children may vary from asymptomatic to life-threatening depending on the Cryptosporidium species/G. duodenalis strains and the resulting complex stepwise interactions between the parasite, the host nutritional and immunologic status, and the gut microbiome profile. Structural damages inflicted by both parasites to epithelial cells in the large and small intestines could severely impair children’s gut health, including the ability to absorb nutrients, resulting in stunted growth, diminished neurocognitive development, and other long-term effects. Clinically approved cryptosporidiosis and giardiasis drugs have broad antimicrobial effects that have incomprehensible impacts on growing children’s gut health.

Cryptosporidium parvum disrupts intestinal epithelial barrier in neonatal mice through downregulation of cell junction molecules

“…C. parvum is an obligatory parasite that doesn't reside inside cells throughout its entire life cycle. During egress and re-invasion, it can cause significant damage to parasitic intestinal epithelial cells [30,31]. Therefore, the damage to intestinal epithelial cells could be raised from apoptosis and inflammatory response stemming from C. parvum infection [32,33].…”

Leading Paediatric Infectious Diseases—Current Trends, Gaps, and Future Prospects in Oral Pharmacotherapeutic Interventions

“…Furazolidone, for treating giardiasis, continues to be a crucial therapeutic agent on a global scale and has received approval for usage in children in the United States [ 154 ]. Its curative rates of 80–96% have been observed for 7–10-day regimens, even though its effectiveness has typically been thought to be slightly lower than those of metronidazole and quinacrine [ 154 , 160 ]. Albendazole and mebendazole, two drugs from the benzimidazole class, have both been used to treat G. lamblia infection, and studies on their efficacy in vivo and in vitro have yielded diverse outcomes [ 161 , 162 ].…”