Marked seasonality of Cyclospora cayetanensis infections: ten-year observation of hospital cases, Honduras

Abstract

BackgroundDocument seasonality occurrence and epidemiologic characteristics of Cyclospora cayetanensis infections during a 10-year period from patients consulting at the University Hospital, Honduras.MethodsRetrospective non interventional hospital-based study analyzed laboratory results from the period 2002 to 2011 of fresh and Ziehl-Nielsen carbolfuchsin stained routine stool samples received for parasitologic examination. Sporadically a sample with numerous oocysts was allowed to sporulate in 2.5 % potassium dichromate confirming the presence of bi-cystic bi-zoic oocysts.ResultsA total of 35,157 fecal samples were examined during a ten-year span, of which a third (28.4 %) was stained by the Ziehl-Neelsen carbolfuchsin method diagnosing a total of 125 (1.3 %) C.cayetanensis infections. A statistically significant apparent seasonality was observed most years during May to August (range p < 0.036–0.001), with 83.3 % of 125 cases occurring in those rainy months. All C. cayetanensis cases came from urban poor neighborhoods; male/female relation was 1:1 except in 2006, when all patients were females (p = 0.05; r2 = 22,448). Forty four point eight percent of the stool samples were diarrheic or liquid and 65.6 % infections were identified in children 10 years old or less. Enteric helminths and protozoa co-infected Cyclospora positive patients in 52 instances.: 8 % Ascaris lumbricoides, 8 % Giardia duodenalis, 23.2 % Blastocystis spp. and less frequently Entamoeba histolytica/E. dispar, Strongyloides stercoralis, and Trichuris trichiura.ConclusionsResults suggest a seasonal pattern for Cyclospora infections diagnosed in a clinical setting during the rainy months in Tegucigalpa and surrounding areas. Community studies should be conducted to support or dispute these observations.

Cyclospora cayetanensis and Cyclosporiasis: An Update

“…Cyclospora cayetanensis infection is remarkably seasonal worldwide [57,58,59,60,61,62]. This seasonality varies by regions, most likely due to human activities, environmental contamination, and the optimal sporulation conditions in each area.…”

Prevalence of Cyclospora cayetanensis and other enteropathogen among children under the age of 15 years in Biratnagar, Nepal

“…C. cayetanensis is an emerging pathogen that is responsible for cyclosporiasis. There is an emerging public health concern about cyclosporiasis and other parasitic infection around the world, but these infections are not routinely sought in the laboratory [11,12]. It is extremely necessary to find out the prevalence of C. cayetanensis in children who are more susceptible to the risk of diarrhoea.…”

Update of Human Infections Caused by Cryptosporidium spp. and Cystoisospora belli, Honduras

“…Methodological standards governing the parasitology laboratory protocols have been in place since 1990 [12,14] to confirm the presence or absence of intestinal parasites or their products of reproduction (trophozoites, cysts, oocysts, eggs, larvae), leukocytes and CharcotLeyden crystals. The routine methodology includes registering macroscopic stool characteristics such as consistency, presence of mucus and/or blood, adult parasites or segments, followed by microscopic stool examination by a direct smear method using physiologic saline solution and a smear in Lugol solution [15].…”

“…As described previously [13,14], the University Hospital is a tertiary care facility in the capital city, Tegucigalpa; a referral hospital for the country serving a poverty or below poverty line population and a teaching hospital adjacent to the School of Medical Sciences from the National Autonomous University of Honduras. The Parasitology Service (PS) serves this 1050 bed-capacity hospital during the morning shift (7:00 a.m. to 2:00 p.m.) daily from Monday to Friday and is composed of a diagnostic section for intestinal parasites and another one for the diagnosis of blood and tissue parasites (malaria, Leishmania spp., Trypanosoma cruzi, Pneumocystis spp.).…”