Aashima Dabas1, Dheeraj Shah, Shinjini Bhatnagar, Rakesh Lodha. 1. Departments of Pediatrics, $AIIMS; University College of Medical Sciences and Guru Teg Bahadur Hospital;and *Chacha Nehru Bal Chikitsalaya; Delhi and #Pediatric Biology Center, Translational Health Science and Technology Institute, Faridabad, Haryana; India. Correspondence to: Dr. Dheeraj Shah, Professor, Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi 110 095, India. shahdheeraj@hotmail.com.
Abstract
CONTEXT: Cryptosporidium spp. is a zoonotic infection, now being recognized as a significant cause of diarrhea in both immunocompetent and immunocompromised hosts. However, there still exist significant knowledge gaps in its estimated global burden, epidemiology, diagnosis and management. EVIDENCE ACQUISITION: A semi-systematic search was performed across PubMed to select studies on epidemiological burden of cryptosporidium diarrhea using the following keywords- ['crytosporidiosis' OR 'cryptosporidium'] AND ['diarrhea' OR 'diarrhoea']. Articles were included if participants were 'Humans', belonged to pediatric (0-18 y) age group, and were published after 1990. The results were compiled separately for acute and persistent diarrhea. RESULTS: Cryptosporidium spp is commonly detected in stools of both cases (acute/ persistent diarrhea) and asymptomatic controls. The prevalence is higher in children with diarrhea than non-diarrheal controls (1.7-35% vs 0.3-15%); varying widely across different studies. The positivity rate is higher in younger children (<2 years) suffering from diarrhea. The main symptoms associated with cryptosporidiosis include fever, vomiting and abdominal pain with propensity for prolonged duration of diarrhea. It predisposes to malnutrition, which is also a risk factor for cryptosporidiosis. The prevalence is higher in HIV positive patients; certain socio-demographic factors play a more important role than mere geographical distribution for infection. CONCLUSION: The high positivity rates during both acute and persistent diarrhea highlights the need to suspect this infection even in immunocompetent children.
CONTEXT: Cryptosporidium spp. is a zoonotic infection, now being recognized as a significant cause of diarrhea in both immunocompetent and immunocompromised hosts. However, there still exist significant knowledge gaps in its estimated global burden, epidemiology, diagnosis and management. EVIDENCE ACQUISITION: A semi-systematic search was performed across PubMed to select studies on epidemiological burden of cryptosporidium diarrhea using the following keywords- ['crytosporidiosis' OR 'cryptosporidium'] AND ['diarrhea' OR 'diarrhoea']. Articles were included if participants were 'Humans', belonged to pediatric (0-18 y) age group, and were published after 1990. The results were compiled separately for acute and persistent diarrhea. RESULTS: Cryptosporidium spp is commonly detected in stools of both cases (acute/ persistent diarrhea) and asymptomatic controls. The prevalence is higher in children with diarrhea than non-diarrheal controls (1.7-35% vs 0.3-15%); varying widely across different studies. The positivity rate is higher in younger children (<2 years) suffering from diarrhea. The main symptoms associated with cryptosporidiosis include fever, vomiting and abdominal pain with propensity for prolonged duration of diarrhea. It predisposes to malnutrition, which is also a risk factor for cryptosporidiosis. The prevalence is higher in HIV positive patients; certain socio-demographic factors play a more important role than mere geographical distribution for infection. CONCLUSION: The high positivity rates during both acute and persistent diarrhea highlights the need to suspect this infection even in immunocompetent children.
Authors: Miranda J Delahoy; Richard Omore; Tracy L Ayers; Katharine A Schilling; Anna J Blackstock; J Benjamin Ochieng; Feny Moke; Peter Jaron; Alex Awuor; Caleb Okonji; Jane Juma; Tamer H Farag; Dilruba Nasrin; Sandra Panchalingam; James P Nataro; Karen L Kotloff; Myron M Levine; Joseph Oundo; Dawn M Roellig; Lihua Xiao; Michele B Parsons; Kayla Laserson; Eric D Mintz; Robert F Breiman; Ciara E O'Reilly Journal: PLoS Negl Trop Dis Date: 2018-07-12