Prevalence of Cryptosporidium-Associated Diarrhea in a High Altitude-Community of Saudi Arabia Detected by Conventional and Molecular Methods

Cryptosporidium diarrhea represents a relevant clinical problem in developing countries. In Al-Taif, a city of Saudi Arabia that lies at an altitude of an around 2 km above the sea level, Cryptosporidium infection seems to be undiagnosed in nearly all clinical laboratories. Furthermore, nothing was published regarding Cryptosporidium-associated diarrhea in this area. The objectives of this research were to (1) determine the Cryptosporidium prevalence among patients with diarrhea and (2) to estimate the performances of 3 different diagnostic methods. Total 180 diarrheal fecal samples, 1 sample per patient, were collected between January and August 2013. Samples were screened for Cryptosporidium with modified Zeihl Neelsen (ZN) microscopy, RIDA(R) Quick lateral flow (LF) immunotest, and a previously published PCR. The Cryptosporidium prevalence rate was 9.4% (17/180), 10% (18/180), and 11.6% (21/180) by microscopy, LF, and PCR test, respectively. Infection was significantly (P=0.004) predominant among children <5 years (22%) followed by children 5-9 years (11.1%). Although infection was higher in males than in females (16.2% males and 8.5% females), the difference was not statistically significant (P=0.11). Compared to PCR, the sensitivity of microscopy and the LF test were 80.9%, 85.7%, respectively. To conclude, high Cryptosporidium-associated diarrhea was found in this area especially in children < or =9 years. The PCR test showed the best performance followed by the LF test and ZN staining microscopy. The primary health care providers in Al-Taif need to be aware of and do testing for this protozoon, particularly for children seen with diarrhea.

Traditional home practices and health seeking behavior among rural mothers who have sick children

Diseases among young children are the major causes of morbidity and mortality particularly in the developing countries. The majority of these morbidities are due to infections, parasitic diseases, diarrhoea and respiratory disease. Health and illness for these children are a result of a complex dynamic of environmental, social, political and economic factors. No single intervention will successfully interrupt the cycle of morbidity and mortality among these children. Children morbidity represents an economic burden through the use of health facilities, health workers time and lost working hours, together with the cost of treatment of these diseases and their complications. Traditional home practices may have directly or indirectly effect on the health of children. To estimate the prevalence of two weeks morbidity and some social and environmental determinants among children less than 5 years in rural area; to identify maternal personal hygiene for sick children with acute diarrhea. In addition, to study the maternal traditional home practices and health seeking behavior for sick children. Cross section study was implemented through interviewing 100 mothers living in rural areas and whose children less than 5 years either at their homes in Betebs village or at RHU. Two weeks morbidity among rural children less than 5 years was high [37%]. Diarrhoea prevalence was 29.7%. Higher percentage of mothers who have children suffered from diarrhea were stored water [54.5%] and [45.5%] were not cover stored water. In addition, all mothers whose children with diarrhoea did not wash their hands with soap and water before cooking. Moreover, only 18.2% of them washed their hands after toilet. Also, mothers/mothers in law were the most important persons as advisors for care seeking among mothers who have children that they suffered from diarrhoea [45.5%]. About eighteen percent of them depend on either their experience or community health nurse, as advisors for care seeking. Health educational program to the community should high light the importance of hand washing with soap and water before cooking, after toilet and after child defecate. Also, intensify sending massages related to home management such as increase fluides, give ORS, ORT and continue BF in mass media and home management skills Health authority personnel should pay attention to the role of community nurse in health education of rural mothers and change their sanitary practices