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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Cryptosporidiosis and microsporidiosis in Ugandan children with persistent diarrhea with and without concurrent infection with the human immunodeficiency virus
American Journal of Tropical Medicine and Hygiene, Volume 73, No. 5, Year 2005
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Description
Cryptosporidium spp. and Enterocytozoon bieneusi are enteric pathogens that have emerged as significant causes of persistent diarrhea (PD) in immunologically compromised individuals particularly in association with HIV/ AIDS. We conducted a cross-sectional study on the clinical epidemiology of E. bieneusi and Cryptosporidium in children with PD, with and without HIV/AIDS, attending Uganda's Mulago National Referral Hospital. Two hundred forty-three children aged < 60 months, admitted between November 2002 and May 2003 with PD (> 14 days), were analyzed for HIV status and CD4 lymphocyte counts, and stools were screened for the presence of E. bieneusi and Cryptosporidium by microscopy and positive samples genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Eighty (32.9%) of the children were excreting E. bieneusi, and 76 (31.3%) were excreting Cryptosporidium. Ninety-one of the 243 children had HIV. of who 70 (76.9%) had E. bieneusi, versus 10 (6.6%) of the 152 without (odds ratio = 47.33; 95% CI = 19.88 to 115.97). while 67 (73.6%) had Cryptosporidium, versus 9 (5.9%) without (odds ratio = 44.36; 95% CI = 18.39 to 110.40). Children with counts < 25% CD4 cells were more likely to have either E. bieneusi (odds ratio = 7.42; 95% CI = 3.77 to 14.69) or Cryptosporidium (odds ratio = 6.45; 95% CI = 3.28 to 12.76) than those with higher CD4 percentages. However, only HIV status was independently associated with either Cryptosporidium or E. bieneusi. Among the 243 children with PD. 67 (27.8%) were infected with both enteric pathogens, with HIV being the only independent predictor of coinfection. Finally, some 81% of HIV-infected children with PD excreted one or both organisms, compared with only 10% of children with PD testing negative for HIV. Seventy-four percent of isolates were C. hominis, the anthroponotic species. 17% were C. parvum, the zoonotic species, and 8% were a mixture of the two or others. Copyright © 2005 by The American Society of Tropical Medicine and Hygiene.
Authors & Co-Authors
Tumwine, James Kashugyera
Uganda, Kampala
School of Medicine, Makerere University College of Health Sciences
Kekitiinwa, Addy
Uganda, Kampala
School of Medicine, Makerere University College of Health Sciences
Bakeera-Kitaka, Sabrina
Uganda, Kampala
School of Medicine, Makerere University College of Health Sciences
Ndeezi, Grace
Uganda, Kampala
School of Medicine, Makerere University College of Health Sciences
Downing, Robert G.
Uganda, Kampala
School of Medicine, Makerere University College of Health Sciences
Feng, Xiaochuan
United States, Grafton
Cummings School of Veterinary Medicine
Akiyoshi, Donna E.
United States, Grafton
Cummings School of Veterinary Medicine
Tzipori, Saul R.
United States, Grafton
Cummings School of Veterinary Medicine
Statistics
Citations: 186
Authors: 8
Affiliations: 2
Identifiers
Doi:
10.4269/ajtmh.2005.73.921
ISSN:
00029637
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Case-Control Study
Study Approach
Quantitative
Study Locations
Uganda