Cryptosporidium Parvum In Patients With And Without Diarrhea In Abuja, Nigeria

摘要

A cross-sectional study was conducted on patients that attended the Federal Staff Hospital, Abuja for the purpose of establishing whether there was a difference between the prevalence of C. parvum in patients with diarrhea compared with those without diarrhea. The stools of a total of 354 patients were examined for the presence of C. parvum infection. The females were more infected than the males, 18 (10.84%) versus 14 (7.45%). In the individuals with diarrhea, the age group of 41-50 years had the highest prevalence of C. parvum infection (3, 33.33%), followed by those that were >50 years of age (2, 20.0%), and 31-40 years (3, 18.75%). In non-diarrhea individuals, those that were aged 31-40 years had the highest prevalence of C. parvum infection, (4, 10.53%), followed by those that were aged >50 years, (1, 7.69%). The mean age of the patients was 22.96 + 0.1 years (range 1-90 years; SD 0.93), with 188 males and 166 females. Diarrhea was present in 129 patients, and 225 had no diarrhea. In 16.28% (21/129) of the patients with diarrhoea, Cryptosporidium parvum was found, while in the control group 4.89% (11/225) was found to have the parasite. Among those with diarrhea, 21 had C. parvum, while 11 did not have diarrhea but had C. parvum. This study provides data for a more appropriate management and laid credence on the importance of routine stool cultures for the detection of coccidian parasites. Introduction Cryptosporidium is a leading cause of persistent diarrhoea in developing countries. With proper oral hydration therapy, full recovery from this coccidian is expected in immunocompetent individuals1. In one study in West Africa, C. parvum was identified to be the most significant pathogen in infections characterized by acute and persistent diarrhea2. Cryptosporidiosis is widespread and affects all ages,3,4,5 and documented evidence indicated the parasite as a cause of diarrhoea in 95 countries6,7. Cryptosporidium is recognized as a significant and widespread cause of diarrheal illness in both immunocompetent and immunosuppressed hosts8. Cryptosporidium may cause severe symptoms in persons with weak immune systems9. The Cryptosporidium species was described as a minute coccidian parasite of the gastric crypts of a laboratory mouse. The first case of human infection was reported in 1978 in a Japanese boy.10,11 The oocysts survive considerable periods in cool, moist environment and resist common disinfections including chlorine, even in excess of those used in water treatment12. Person -to- person transmission is now recognized to be common by faecal-oral route, directly or through formites12. Infected individuals may excrete many millions of oocysts each day during the acute stage4. Infected human and animal hosts usually contaminate potable water, food and formities. Open sewage systems provide the commonest routes of discharge of pathogens into freshwater in urban areas. In addition, human and animal waste points constitute a major source. The genus Cryptosporidium is a phenotypically and genotypically heterogenous assemblage of largely morphologically identified species and genotypes. Fourteen species and twenty-one C. parvum genotypes are currently recognized13.Cryptosporidium transmission occurs at a high frequency in day care centers where children are clustered within classrooms, share toilets and common play areas, or necessitate frequent diaper changing14. Materials And Methods Study design: A cross-sectional study was conducted on patients that attended the Federal Staff Hospital, Abuja, from June 2005 to April 2006, in order to determine the prevalence of C. parvum. Stool samples were collected from recruited members and placed in disposable plastic cups, with subsequent addition of 10% formalin as a preservative before analysis, and in accordance with institutional ethical guidelines. All the stool samples for parasitological investigation were processed in the laboratory of the hospital.Stool examination: the para