ABSTRACT
A 13-month study of children presenting with acute diarrhoeal disease at hospitals and rehydration clinics in Antananarivo, Madagascar, was undertaken between May 2004 and May 2005. Cryptosporidiosis accounted for diarrhoea in 12 (5.6%) of the 215 children investigated. Cases of cryptosporidiosis were detected only in the rainy season, and the median age of cases was 13.5 months (range=1 day-27 months). As 11 of the cases of cryptosporidiosis were caused by Cryptosporidium hominis and only one by C. parvum, most of the cases were probably the result of anthroponotic transmission. GP60/45/15 gene polymorphisms indicated that the causative pathogens were of subtypes Ia, Id, Ie and IIc.
Subject(s)
Cryptosporidiosis/epidemiology , Diarrhea/parasitology , Animals , Child, Preschool , Cryptosporidiosis/transmission , Cryptosporidium/genetics , Diarrhea/epidemiology , Feces/parasitology , Female , Genotype , Humans , Infant , Infant, Newborn , Madagascar/epidemiology , Male , SeasonsABSTRACT
Background: Cyclosporiasis is an emerging gastro-enteric disease caused by the coccidia protozoan Cyclospora cayetanensis. It isassociated with diarrhoea among children in developing countries; in the Americas where C. cayetanensis is endemic; traveller's diarrhoea and/or food and waterborne outbreaks in the developed countries. Objectives: The aim of this review is to highlight cyclosporiasis and its relevance to public health in East Africa and Africa at large. Methods: All literature on Cyclospora; C. cayetanensis; cyclosporiasis in Africa; and endemic cyclosporiasis was searched from libraries;colleagues and internet but only literature on its history; clinical presentation; epidemiology in endemic settings; and occurrence inAfrica were scrutinised. Results: In Sub Saharan Africa; cyclosporiasis has been reported in at least 3 countries; including Tanzania; in East Africa; occurring inboth immunocompromised and immunocompetent patients. Zoonotic species of Cyclospora have also been identified in East African primates; indicating likely endemicity of this little reported disease in the region. This can be attributed to lack of awareness in thepublic and medical profession concerning the disease; and therefore not routinely checked at the health centres. Cyclosporiasis ischaracterized by intermittent diarrhoea; and secondary conditions or sequelae such as reactive arthritis syndrome (Reiter's syndrome); have been associated with progression of the disease. Its management is based on antibiotics; an unusual scenario for a protozoa. Conclusions: Although many aspects of this disease and its transmission remain an enigma; the situation has been rapidly changing since the disease first came to medical attention in the 1970s
Subject(s)
Cyclospora , Cyclosporiasis , Public HealthABSTRACT
To assess the importance of dairy cattle as a source of human Cryptosporidium infections in Ontario, Canada, 44 Cryptosporidium isolates from neonatal dairy calves and 11 from sporadic human cases of cryptosporidiosis in the province were genotyped by PCR-RFLP analyses of the Cryptosporidium oocyst wall protein (COWP) and 18S rRNA genes. Isolates were also subtyped by sequence analysis of the 60-kDa glycoprotein (GP60) gene. All bovine isolates successfully subtyped belonged to Cryptosporidium parvum subtype family (allele) IIa. Seven subtypes of this family were identified among the bovine isolates. Four human isolates were Cryptosporidium hominis, of alleles Ia, Id, and Ie. Of the remaining seven human specimens, four were C. parvum allele IIa, two were C. parvum of an undetermined subtype, and one was identified as Cryptosporidium cervine genotype. Three of the C. parvum isolates from humans were the same subtypes as isolates from the calves. These findings suggest that cattle and other ruminants may be a source of sporadic human infections in Ontario. This is the first published description of Cryptosporidium genotypes and subtypes in Ontario, and is the second published report of human infection with Cryptosporidium cervine genotype.
Subject(s)
Cattle Diseases/parasitology , Cryptosporidiosis/veterinary , Cryptosporidium/genetics , Parasitic Diseases, Animal/parasitology , Protozoan Proteins/genetics , Animals , Base Sequence , Cattle , Cryptosporidiosis/parasitology , Cryptosporidium/isolation & purification , DNA, Protozoan/analysis , Feces/parasitology , Genotype , Humans , Molecular Sequence Data , Ontario , Phylogeny , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , RNA, Ribosomal, 18S/analysis , Sequence Analysis, DNA , ZoonosesABSTRACT
The epidemiology of chronic diarrhoea in adults with late-stage HIV infection was investigated in a prospective study in Bangkok, Thailand. During this investigation, 34 Cryptosporidium isolates were obtained from the faeces of 36 patients, with mean CD4(+) counts of only 14 x 10(6) CD4(+) cells/litre (range = 2 x 10(6) - 53 x 10(6)/litre), who had symptomatic cryptosporidiosis. Genotyping of these isolates, by RFLP analysis and DNA sequencing of the hypervariable region of the 18S rRNA gene, indicated that only 17 (50%) were of the C. parvum human genotype. The rest were of C. meleagridis (seven), the C. parvum 'bovine' genotype (five), C. felis (three) and C. canis (two). Extensive genotypic heterogeneity was observed among the C. parvum isolates, and two other isolates, one of C. meleagridis and the other of C. felis, produced atypical restriction patterns and were only identified by sequencing. This appears to represent the first report of C. canis and the 'bovine' genotype of C. parvum in HIV-infected Thai patients.
