Epidemiology of diarrhoeal disease in rural Malawi - a case study of cryptosporidiosis

摘要

A rural community based case control study was conducted in Malawi, over a 23 month period, to identify determinants influencing human cryptosporidiosis in under fives. 96 home interviews were conducted in 24 communities (cases n=24; unmatched controls n=72). 61 risk factors were investigated by questionnaire, combined with quantitative data from drinking water and domesticated animal stool samples. Cryptosporid-ium oocysts were not detected in either sample type. Multivariate logistic regression of questionnaire data revealed an increased risk of cryptosporidiosis associated with ownership of pigs (OR7.2, 95%CI 1.9-27.5, p=0.004), presence of diarrhoea in the household (OR8.8, 95%CI 1.8-53.4, p=0.008), bathing in the river (OR76.7, 95%CI 1.1-23.8, p=0.037) and no education within the household (OR3.6, 95%CI 1.1-11.8, p=0.038). Bacteriological results indicating faecal contamination of both drinking water stored within the home, and the surface of guardians 'hands were indicative of poor hygienic practices and potential sources of infection.