Detection of cyclospora cayetanensis infections among diarrheal children attending Suez Canal University Hospital

ABSTRACT

The objective of the present study is to detect the occurrence of Cyclospora cayetanensis among diarrheal children with or without immunosuppressant conditions. Stool samples were collected and examined for identification of the parasite using different concentration methods [Formaline ethely acetate, Potassium hydroxide and Sheather's floatation] and different stains [acid fast, modified Ziehl Neelsen, modified Kinyoun and modified safranin]. Confirmation of the results was performed using autofluorescence technique. Cyclospora oocysts were detected in 19.6% of 230 diarrheal children without immunosuppressant conditions and 34.6% of 230 diarrheal children with immunosuppressant conditions with significant difference between the two groups. Sheather's floatation method was significantly more sensitive than direct smear, FEA and KOH sedimentation methods [with sensitivities of 93.6%, 63.7%, 75.8% and 79.8%, respectively]. Additionally, the modified safranin was the best staining method as it was significantly more sensitive than the acid fast and the modified Ziehl Neelsen staining. On the other hand, no significant differences were found between the acid fast, the modified Ziehl Neelsen or the modified Kinyoun staining. Cyclosporiasis predominated in the age group 1-4 years compared to other age groups. There was a significant association between infection with Cyclospora and low socioeconomic level, living in rural areas and using tap water. Cyclospora was found as a sole parasite in 55 out of 124 [44.4%] infected children. Co-infection with other pathogenic parasites occurred in 69 cases; most commonly Cryptosporidium [30/124]. It was concluded that cyclosporiasis is common among diarrheal children especially if it is associated with immunosuppressant conditions. Feces examination for oocysts using Sheather's floatation and the modified safranin staining are recommended for diagnosis