Household Epidemiology of Cryptosporidium parvum Infection in an Urban Community in Northeast Brazil

Newman, Robert D.; Zu, Shu Xian; Wuhib, Tadesse; Lima, Aldo A. M.; Guerrant, Richard L.; Sears, Cynthia L.

doi:10.7326/0003-4819-120-6-199403150-00009

Cited by 123 publications

(76 citation statements)

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“…may occur on account of various factors: methodology in processing of feces, degree of development in each region and characteristics of different populations 10 . Although some studies 23,24 attribute episodes of diarrhea in developing areas to Cryptosporidium sp., in this inquiry it was not evidenced, as only nine of the 42 positive children were symptomatic. The agglomeration of children, common in nursery schools (person-to-person contact), appears to be the principal potentializing factor for the transmission of Cryptosporidium sp.…”

Section: Discussionmentioning

confidence: 99%

Occurrence of enteroparasites in day care centers in Botucatu (São Paulo State, Brazil) with emphasis on Cryptosporidium sp., Giardia duodenalis and Enterobius vermicularis

Carvalho

Mascarini

2006

Rev. Inst. Med. trop. S. Paulo

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SUMMARYThe occurrence of the enteroparasites was verified in 279 children (0 to 6 years) of four municipal day cares of Botucatu/SP. Three samples of each child's feces were collected and processed by the methods of Hoffman-Pons-Janner, Faust and Ritchie and subsequent coloration of the fecal smear by the methods of Auramina-O and Ziehl-Neelsen modified for diagnosis of Cryptosporidium sp. and Graham method for diagnosis of Enterobius vermicularis. Of the analyzed children we verified a prevalence of intestinal parasitism in 53.40%, and the most frequent parasite was Giardia duodenalis (26.88%). Significant association was verified among enteroparasitosis, family income, maternal education and age; the lowest enteroparasite frequency occurred in children of families with larger income and higher education. It was observed that G. duodenalis is more prevalent in children from 0 to 4 years and E. vermicularis is more frequent in children between three and four years old. The high enteroparasite prevalence in day cares suggests complex structure in its epidemiology, where factors beyond sanitation should be considered.

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Section: Discussionmentioning

confidence: 99%

Occurrence of enteroparasites in day care centers in Botucatu (São Paulo State, Brazil) with emphasis on Cryptosporidium sp., Giardia duodenalis and Enterobius vermicularis

Carvalho

Mascarini

2006

Rev. Inst. Med. trop. S. Paulo

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“…A high secondary infection rate (39%) was reported in the households in which children with Cryptosporidium infection were identified. 11 Another factor would be heavy rains and flooding that could lead to the spread of environmental contamination by oocysts and favor water-borne transmission of Cryptosporidium. Although drinking boiled water is a common practice among individuals in our study area, unboiled water would probably be used for food preparation, washing, hands, and taking baths.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10] Infection occurs by ingestion of oocysts either through human-to-human or animal-to-human contact, or via contaminated water. 5,6,[11][12][13][14][15][16] Despite its wide distribution and obvious relevance to public health, Cryptosporidium remains a little-studied protozoan in Indonesia. The present studies were undertaken to 1) assess the importance of Cryptosporidium in the causation of acute diarrhea among patients of all age groups who visited a hospital, and 2) understand the community prevalence and the mode of transmission of Cryptosporidium infection in Surabaya, Indonesia.…”

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confidence: 99%

Cryptosporidiosis in Indonesia: a hospital-based study and a community-based survey.

Katsumata¹,

Hosea²,

Wasito³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. Hospital-based and community-based studies were conducted to understand the prevalence and mode of transmission of Cryptosporidium parvum infection in Surabaya, Indonesia. In both studies people with and without diarrhea were examined for oocysts. A community-based survey included questionnaires to a community and stool examination of cats. Questionnaires covered demographic information, health status, and hygienic indicators. In the hospital, C. parvum oocysts were found in 26 (2.8%) of 917 patients with diarrhea and 15 (1.4%) of 1,043 control patients. The most susceptible age was less than two years old. The prevalence was higher during the rainy season. A community-based study again showed that C. parvum oocysts were frequently detected in diarrhea samples (8.2%), exclusively during rainy season. Thirteen (2.4%) of 532 cats passed C. parvum oocysts. A multiple logistic regression model indicated that contact with cats, rain, flood, and crowded living conditions are significant risk factors for Cryptosporidium infection.The protozoan Cryptosporidium parvum is now recognized as an important cause of diarrhea in both immunocompetent and immunosuppressed patients. A number of surveys carried out in recent years have described the worldwide distribution of Cryptosporidium. [1][2][3][4][5][6][7][8][9][10] The prevalence of Cryptosporidium infection is higher among children than among adults and is more common in developing countries than in developed countries. 1-10 Infection occurs by ingestion of oocysts either through human-to-human or animal-to-human contact, or via contaminated water. 5,6,[11][12][13][14][15][16] Despite its wide distribution and obvious relevance to public health, Cryptosporidium remains a little-studied protozoan in Indonesia. The present studies were undertaken to 1) assess the importance of Cryptosporidium in the causation of acute diarrhea among patients of all age groups who visited a hospital, and 2) understand the community prevalence and the mode of transmission of Cryptosporidium infection in Surabaya, Indonesia. MATERIALS AND METHODSStudy population and sample collection. Hospital-based study. Observations were made over a period of one year from August 1992 to July 1993 at the Dr. Soetomo Hospital, which is part of the University of Airlanaga in Surabaya. The hospital has 1,466 beds. During the study period, 92,061 patients visited the hospital and 41,622 patients were admitted. At total of 3,892 of 41,622 in-patients and 1,982 of 50,439 out-patients had diarrhea. The study population consisted of 917 patients with acute diarrhea: 715 in-patients and 202 out-patients. A group of 1,043 in-patients selected during the study period served as controls; none of these patients had any gastrointestinal problems. A stool specimen was collected from each patient within 24 hr of visiting the hospital.Community-based study. The studies were conducted in eight communities in Surabaya during the rainy season (December 1992 to March 1993) and dry season (June to July 1993). The total ...

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“…The complete description of the study area and population has been presented previously (Newman et al, 1994(Newman et al, , 2001). The poor, urban shantytown (favela) of Gonçalves Dias with about 2000 residents is located within the capital city of Fortaleza, in the northeastern Brazilian state of Ceará.…”

Section: Study Area and Populationmentioning

confidence: 99%

Giardia duodenalis assemblage, clinical presentation and markers of intestinal inflammation in Brazilian children

Kohli

Bushen

Pinkerton

et al. 2008

Transactions of the Royal Society of Tropical Medicine and Hygi

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135

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SummaryData on the relationship between the two genotypes of Giardia duodenalis that infect humans, assemblages A and B, their clinical presentation and intestinal inflammation are limited. We analyzed 108 stool samples previously collected for a diarrhoeal study among Brazilian children, representing 71 infections in 47 children. Assemblage B was most prevalent, accounting for 43/58 (74.1%) infections, while assemblage A accounted for 9/58 (15.5%) infections and 6/58 (10.3%) infections were mixed (contained both assemblage A and B). There was no significant difference in diarrhoeal symptoms experienced during assemblage A, B or mixed infections. Children with assemblage B demonstrated greater variability in G. duodenalis cyst shedding but at an overall greater level (n = 43, mean 3.6 × 10 5 , range 5.3 × 10 2 -2.5 × 10 6 cysts/ml) than children infected with assemblage A (n = 9, mean 1.4 × 10 5 , range 1.5 × 10 4 -4.6 × 10 5 cysts/ml; P = 0.009). Children with mixed infections shed more cysts (mean 8.3 × 10 5 , range 3.1 × 10 4 -2.8 × 10 6 cysts/ml) than children with assemblage A or B alone (P = 0.069 and P = 0.046 respectively). This higher rate of cyst shedding in children with assemblage B may propagate its spread, accounting for its increased incidence. Additionally, second and third infections had decreasing faecal lactoferrin, suggesting some protection against severity, albeit not against infection, by prior infection. Authors' contributions: AAML, RLG, AK and OYB designed the study protocol; RDN, AK and OYB carried out the clinical assessment; AK carried out and EH designed and carried out the quantitative PCR of Giardia; AK, RCP, OYB, CLS and RDN carried out the analysis and interpretation of these data; AK, OYB, RDN and CLS drafted the manuscript. All authors read and approved the final manuscript. AK and RLG are guarantors of the paper.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conflicts of interest: None declared.Ethical approval: The study protocol and informed consent were approved by the human investigations committees of the Federal

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Household Epidemiology of Cryptosporidium parvum Infection in an Urban Community in Northeast Brazil

Cited by 123 publications

References 0 publications

Occurrence of enteroparasites in day care centers in Botucatu (São Paulo State, Brazil) with emphasis on Cryptosporidium sp., Giardia duodenalis and Enterobius vermicularis

Occurrence of enteroparasites in day care centers in Botucatu (São Paulo State, Brazil) with emphasis on Cryptosporidium sp., Giardia duodenalis and Enterobius vermicularis

Cryptosporidiosis in Indonesia: a hospital-based study and a community-based survey.

Giardia duodenalis assemblage, clinical presentation and markers of intestinal inflammation in Brazilian children

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