BackgroundCryptosporidiosis is an important cause for chronic diarrhea and death in HIV/AIDS patients. Among common Cryptosporidium species in humans, C. parvum is responsible for most zoonotic infections in industrialized nations. Nevertheless, the clinical significance of C. parvum and role of zoonotic transmission in cryptosporidiosis epidemiology in developing countries remain unclear.Methodology/Principal FindingsIn this cross-sectional study, 520 HIV/AIDS patients were examined for Cryptosporidium presence in stool samples using genotyping and subtyping techniques. Altogether, 140 (26.9%) patients were positive for Cryptosporidium spp. by PCR-RFLP analysis of the small subunit rRNA gene, belonging to C. parvum (92 patients), C. hominis (25 patients), C. viatorum (10 patients), C. felis (5 patients), C. meleagridis (3 patients), C. canis (2 patients), C. xiaoi (2 patients), and mixture of C. parvum and C. hominis (1 patient). Sequence analyses of the 60 kDa glycoprotein gene revealed a high genetic diversity within the 82 C. parvum and 19 C. hominis specimens subtyped, including C. parvum zoonotic subtype families IIa (71) and IId (5) and anthroponotic subtype families IIc (2), IIb (1), IIe (1) and If-like (2), and C. hominis subtype families Id (13), Ie (5), and Ib (1). Overall, Cryptosporidium infection was associated with the occurrence of diarrhea and vomiting. Diarrhea was attributable mostly to C. parvum subtype family IIa and C. hominis, whereas vomiting was largely attributable to C. hominis and rare Cryptosporidium species. Calf contact was identified as a significant risk factor for infection with Cryptosporidium spp., especially C. parvum subtype family IIa.Conclusions/SignificanceResults of the study indicate that C. parvum is a major cause of cryptosporidiosis in HIV-positive patients and zoonotic transmission is important in cryptosporidiosis epidemiology in Ethiopia. In addition, they confirm that different Cryptosporidium species and subtypes are linked to different clinical manifestations.

BackgroundGiardia and Cryptosporidium are the most common causes of protozoan diarrhea that lead to significant morbidity and mortality worldwide. The purpose of this study was to determine the prevalence of Giardia duodenalis and Cryptosporidium species infections among children and cattle, and to assess the potential risk of zoonotic transmission.MethodsThis cross-sectional study was conducted between January and April 2009 in Girar Jarso and Dera Districts of North Shewa Zone, Oromia Region, Ethiopia. A total of 768 stool specimens were collected and examined for intestinal parasites using direct wet mount with saline and formalin ether concentration methods. The modified Ziehl-Neelsen staining method was used for the detection of Cryptosporidium species. Statistical analysis was performed using SPSS software version 15.ResultsOut of 384 children examined, 53 (13.8%) and 28 (7.3%) were positive for Giardia and Cryptosporidium infections, respectively. Similarly, of the total 384 cattle examined, 9 (2.3%) were positive for Giardia duodenalis and 30 (7.8%) were positive for Cryptosporidium infection. The prevalence of giardiasis was significantly higher among children who had close contact with cattle 33 (18.7%) compared to children who had no contact with cattle 20 (9.6%) (P < 0.05). Higher number of Cryptosporidium infection was also recorded in children who had close contact with cattle 15 (8.5%). Difference in prevalence of giardiasis and cryptosporidiosis among children was not statistically significant between males and females. On the other hand, difference in the prevalence of giardiasis among children was statistically significant between age groups.ConclusionsHigher prevalence of Giardia duodenalis infection detected among children was significantly associated with contact with cattle and manure that the children had. Further analysis using molecular techniques is needed to explain the existence of zoonotic transmission in the study area.

Background: In developing countries, gastroenteritis caused by intestinal parasites may be complicated and is a major cause of morbidity, in general, and kills millions of AIDS patients annually. Thus, the consequences of parasitic diseases are among the major health problems in tropical developing countries. Methods: A total of 200 HIV positive patients on and without-ART aged from 18 to 65 years, of both sexes participated in the study. Each study participant was provided with a faecal collection vial containing 10% formalin for microscopic examination of ova, larvae, and cysts. For detection of Cryptosporidium spp, lsospora belli and Cyclospora spp, the modified Zeihl-Neelsen staining method was used. Results: Most (60%) of the study participants were on antiretroviral therapy (ART). Out of those, only two (1.5%) were diagnosed with an opportunistic parasite, and 96 (48%) of the non-ART study participants were infected with at least one other intestinal parasite species. The prevalence was 16% for Giardia lamblia, 13% for Entamoeba histolytica/ E. dispar, 8% for Cryptosporidium spp, 5% for Isospora belli, 1.5% for Blastocystis hominis, 2.5% for Ascaris lumbricoides and 2% for Hymnolepis nana. Diarrhoea was significantly associated with cryptosporidiosis, giardiasis, and isosporiasis. Significant association was observed between lower CD4 + T cell count (<200 cells/µL) and the prevalence of Cryptosporidium spp, Isospora belli, and Blastocystis hominis. The three parasites were significantly prevalent in HIV sero-positive patients not on-ART. Conclusion: The finding showed that patients under ART had lower prevalence of diarrheogenic protozoan parasites suggesting that ART through improvement of the immune status of patients may have contributed to controlling parasites in HIV/AIDS patients. [Ethiop.