Genetic Characterization of Cryptosporidium spp. in Diarrhoeic Children from Four Provinces in South Africa

Abstract

Summary The diversity of Cryptosporidium at species, subtype family and subtype level in diarrhoeic children was investigated in four provinces in South Africa. A total of 442 stool samples from children <5 years of age were collected under a large rotavirus surveillance programme and analysed by Ziehl–Neelsen acid‐fast staining. Fifty‐four (12.2%) were positive for Cryptosporidium, of which 25 were genotyped by polymerase chain reaction (PCR)–restriction fragment length polymorphism (RFLP) and DNA sequence analyses of the 18S rRNA gene. The majority of genotyped specimens were identified as C. hominis (76%), and a high genetic diversity was found with five different C. hominis subtype families (Ia, Ib, Id, Ie and If). Cryptosporidium parvum was found in 20% of the isolates, and three subtype families were identified (IIc, IIe and IIb), with subtype family IIc being the most common. One specimen was identified as C. meleagridis of the subtype family IIId. These results are in accordance with findings from other developing countries and report for the first time the presence in South Africa of C. meleagridis, various subtypes of C. parvum and the subtype family Ie of C. hominis. The results suggest that C. hominis and anthroponotic C. parvum subtypes are the major cause of cryptosporidiosis in South Africa. Further molecular studies are needed to better understand the epidemiology and public health importance of Cryptosporidium in humans in South Africa.

Cryptosporidium spp., Giardia duodenalis, Enterocytozoon bieneusi and Other Intestinal Parasites in Young Children in Lobata Province, Democratic Republic of São Tomé and Principe

“…The C. hominis Ia subtype family observed in this study has been reported as one of the predominant subtype families in humans [45], including Nigeria [36], [44], [46], [47]. The C. hominis Ie subtypes identified, IeA11G3T3 (28.6%) and IeA11G3T3R1 (21.4%) have been reported in human infections from other african low-middle income countries, such as Nigeria [44], [46] and South Africa [41]. Similarly, to our results, in most low-middle income countries, humans with the subtype family Ie are mostly infected with subtype IeA11G3T3, with few exceptions for Jamaica and China where IeA12G3T3 has been detected [48], [49] …”

“…Variations in the distribution of Cryptosporidium species in humans are considered an indication of differences in infection sources [18]. The predominance of C. hominis has also been reported in other paediatric populations in Africa, such as in South Africa [39]–[41] Malawi [42], Kenya [43], Uganda [35] and Nigeria [44], indicating that anthroponotic transmission may play a major role in the epidemiology of Cryptosporidium in this continent.…”

“…Both C. hominis Ia and Ie subtype families characterized in this study are included in the group of the four most commons subtype families (Ia, Ib, Id and Ie) that are usually observed in children in developing countries [9], [41], [44]. Infections with the Ia and Ie subtype families were more likely asymptomatic [17].…”

The Evolution of Respiratory Cryptosporidiosis: Evidence for Transmission by Inhalation

“…In the largest study of respiratory cryptosporidiosis to date, 13 of 17 Ugandan children (76%) with Cryptosporidium-positive sputa and feces were infected with C. hominis, while the remaining 4 were infected with C. parvum (25), reflecting the species isolation rates from the gastrointestinal tract. C. meleagridis, another species producing diarrhea and suspected to cause respiratory disease in birds (75), has also been isolated from African children with diarrhea (11,12,131,132). This parasite has been found in the intestinal tracts of HIV/ AIDS patients (133,134), but the role of C. meleagridis in human respiratory cryptosporidiosis has so far not been reported.…”

Sapovirus prevalence in children less than five years of age hospitalised for diarrhoeal disease in South Africa, 2009–2013

“…Specimens were screened for SaV in monoplex reactions using 5µl cDNA, LightCycler 480 Probe Master Kit (Roche) and primers and probes from a published method [22]. Screening for other enteric viruses, bacteria and parasites has been described elsewhere [23,24]. Dried blood spots were tested using the AmpliPrep (Roche) for automated extraction; and COBAS TaqMan (Roche) for automated real-time detection of HIV-1.…”