ABSTRACT
Objective: The objective of this study is to search for Cryptosporidium parvum in Sudanese immunocompromised and immunocompetent patients presenting with diarrhea. Methods: Two hundred and thirteen stool specimens were collected from different groups of patients presenting with diarrhea and healthy control (immunocompromised: 78; immunocompetent: 90; Control: 45). The immunocompromised group included 25 HIV positive patients; 27 tuberculosis patients; 11 patients with renal failure and 15 patients receiving immunosuppressive chemotherapy. Antigen ELISA was performed to detect the presence of the parasite in stool. Positive specimens were examined by the modified ZN stain to look for the oocyst of C.parvum. Result: Seventy one of the immunocompromised patients (91.0); twenty nine of immunocompetent patients (32.2) and ten of the control group (22.2) were found to be positive for C.parvum. A significant difference was noticed between the immunocompromised patients and the other groups (P0.05). Among the immunocompromised patients; the highest percentage of positive results (96.1) was in the HIV patients. The percentage of positive results within the tuberculosis; renal failure and immunosuppressive patients were 92.6; 83.3and 86.6respectively. Conclusion: The significant detection of C. parvum among the different groups of immunocompromised should raise the awareness of the clinicians towards this parasite as an important cause of diarrhea in such groups of patients
Subject(s)
Cryptosporidium parvum , Diarrhea/etiology , Immunocompromised HostABSTRACT
Chronic diarrhoea was defined as 2 or more unusually loose stools daily for at least a month. For each patient; a single stool specimen was collected and concentrated with formal- ether concentration method. Two air dried thin smears were then stained by a modified Kinyoun method for cryptosporidium. One observer (M.R) did all the microscopy. Cryptosporidium oocytes were detected in 36of AIDS patients (Chi-square test and P respectively) although cryptosporidium is found 8 times more in AIDS patients. There is also a high frequency of asymptomatic cyst-passers in this area among AIDS patients but not in the healthy controls. Cryptosporidium parvum is a well known opportunitic infection in AIDS patients with diarrhoea although it is now recognised as a frequent cause of diarrhoea in otherwise healthy humans as well. Investigations for cryptosporidium infection in Africa have mainly focused on AIDS patients with chronic diarrhoea and it has been found frequently in such patients; at a prevalence rate varying from 4to 48. The aim of this study was to assess and compare the prevalence of cryptosporidium in four groups: 1. AIDS patients with chronic diarrhoea (50 cases). 2. AIDS patients without diarrhoea (50 cases)