Microsporidiosis and Malnutrition in Children with Persistent Diarrhea, Uganda

Mor, Siobhan M.; Tumwine, James K; Naumova, Elena N.; Ndeezi, Grace; Tzipori, Saul

doi:10.3201/eid1501.071536

Cited by 31 publications

(25 citation statements)

References 12 publications

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“…4 It is also a common parasite in animals. 5 The infective form of E. bieneusi is the resistant spore that is commonly found in ditch and other water bodies.…”

Section: Introductionmentioning

confidence: 99%

Molecular Epidemiologic Characterization of Enterocytozoon bieneusi in HIV-Infected Persons in Benin City, Nigeria

Akinbo¹,

Okaka²,

Omoregie³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Molecular characterization of Enterocytozoon bieneusi has led to better understanding of microsporidiosis transmission in humans. This study aimed to detect and genotype E. bieneusi in human immunodeficiency virus (HIV)-infected persons. Stool specimens were collected from 463 HIV-infected patients and analyzed for E. bieneusi by polymerase chain reaction (PCR) and DNA sequence analysis of the internal transcribed spacer. E. bieneusi was detected in 77 HIV patients. CD4 cell counts < 200 cells/μL was associated with E. bieneusi infection (P = 0.09). E. bieneusi was significantly associated with weight loss (P < 0.0001), diarrhea (P = 0.006), fever (P < 0.0001), not being married (P < 0.0001), and flush type of toilet (P = 0.0007). Six known genotypes of D, A, IV, CAF2, EbpA, and Peru 8 in 31, 22, 14, 2, 1, and 1 patients, respectively, five novel genotypes of E. bieneusi, and one infection with mixed genotypes were observed in this study. Three of the novel genotypes were genetically distant to the genotypes commonly found in humans.

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“…4 It is also a common parasite in animals. 5 The infective form of E. bieneusi is the resistant spore that is commonly found in ditch and other water bodies.…”

Section: Introductionmentioning

confidence: 99%

Molecular Epidemiologic Characterization of Enterocytozoon bieneusi in HIV-Infected Persons in Benin City, Nigeria

Akinbo¹,

Okaka²,

Omoregie³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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“…Phylogenetic analysis of ITS sequences revealed the presence of several genotypic groups: a large group (group 1) of closely related genotypes found in both humans and many animals, groups (groups 2 to 5) of host-adapted genotypes associated with specific animal hosts with no major public health importance, a small group (group 7) found in Nigerian AIDS patients, and a group found in urban wastewater (group 6) in China (5,14).…”

mentioning

confidence: 99%

“…Enterocytozoon bieneusi, the most common species among approximately 14 humanpathogenic microsporidian species, is responsible for diarrhea and enteric diseases in various mammals and birds (5). It is one of the major causes of opportunistic infections in immunocompromised persons (3,6) and has commonly been reported in children with diarrhea or malnutrition (7) and in other immunocompetent individuals (8). Although the infective stage of E. bieneusi, i.e., the environmentally resistant spore, has commonly been detected in many different hosts and water, little is known regarding the environmental source of microsporidia for the human population (4,9,10).…”

mentioning

confidence: 99%

Genetic Polymorphism and Zoonotic Potential of Enterocytozoon bieneusi from Nonhuman Primates in China

Karim

Wang

Dong

et al. 2014

Appl Environ Microbiol

137

135

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g Enterocytozoon bieneusi is an important zoonotic pathogen. To assess the human-infective potential of E. bieneusi in nonhuman primates (NHPs), we examined the prevalence and genotype distribution of E. bieneusi in 23 NHP species by PCR and sequence analysis of the ribosomal internal transcribed spacer (ITS). A total of 1,386 fecal specimens from NHPs from five provinces in China were examined, and E. bieneusi was detected in 158 (11.4%) specimens from five NHP species, including cynomolgus monkey (67.7%), rhesus macaque (8.8%), Japanese macaque (33.3%), white-headed langur (13.6%), and golden snub-nosed monkey (3.5%) (P < 0.0001). The infection rates were 70.2%, 21.5%, 8.5%, 7.5%, and 5.6% in Guangdong, Yunnan, Guangxi, Henan, and Sichuan Provinces, respectively (P < 0.0001). The prevalence was significantly higher in captive (13.7%) than in freerange (5.0%) animals (P < 0.0001). Altogether, 16 ITS genotypes were observed, including nine known genotypes (IV, D, Henan V, Peru8, PigEBITS7, EbpC, Peru11, BEB6, and I) and seven new genotypes (CM1 to CM7). The common genotypes included CM1, IV, and D, which were detected in 43, 31, and 30 specimens, respectively. Phylogenetic analysis revealed that seven known genotypes (but not BEB6 and I) and four new genotypes (CM1, CM2, CM3, and CM6) belonged to the previously described group 1 with zoonotic potential. Genotypes CM5 and CM7 clustered with group 2, whereas genotype CM4 did not belong to any of the previously proposed groups. It was concluded that humans and NHPs residing in the same geographical location shared the same E. bieneusi genotypes, indicating a potential role of these animals in the zoonotic transmission of E. bieneusi.

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“…Por outro lado, como é sabido que a DP pode ocorrer em pacientes com síndrome da imunodeficiência adquirida (AIDS), deve-se avaliar a presença dos agentes encontrados com maior frequência em pacientes HIV positivo. Estudo realizado no continente africano concluiu que a infecção pelo Mycrosporidium está associada a essa imunodeficiência, provocando e contribuindo para a manutenção de lesões intestinais mais extensas que as observadas em outras infecções oportunísticas 31 . Diante desse fato, é recomendado que esses agentes devam ser investigados e que alternativas terapêuticas sejam estudadas para emprego em crianças de baixa idade.…”

Section: Diagnósticounclassified

Persistent diarrhea: still an important challenge for the pediatrician

Andrade¹,

Fagundes-Neto²

2011

J Pediatr (Rio J)

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Objective: To provide recent guidelines to reduce the incidence of diarrheal diseases. We discuss the definition, clinical aspects, pathophysiology, diagnosis, management, and prevention of persistent diarrhea.Sources: Electronic search of the MEDLINE database, Google search. Summary of the findings:Acute diarrhea may be caused by a variety of agents, including bacterial, viral, and protozoan pathogens. The top priority in treatment of diarrhea is replacement of fluid and electrolytes losses, particularly at the acute stage, and, under certain circumstances, eradication of the enteropathogenic agent. On the other hand, treatment of persistent diarrhea should focus on prevention and management of food intolerance and malnutrition.Conclusions: Promotion of breastfeeding, adequate interventions in the treatment of acute diarrheal episodes, introduction of safe dietary strategies for prevention of malnutrition, and improvements in sanitation and hygiene conditions, including sewage and clean water, are essential measures for the reduction of diarrheal morbidity and mortality rates in children under 5 years of age.J Pediatr (Rio J). 2011;87(3):199-205: Malnutrition, morbidity, mortality, diarrhea, food hypersensitivity, breastfeeding. ResumoObjetivo: Fornecer as diretrizes mais recentes de diminuição da incidência da doença diarreica, abordando os aspectos clínicos, a etiologia, a fisiopatologia, o diagnóstico, o manejo terapêutico e a profilaxia da diarreia persistente. Fontes dos dados:Busca eletrônica de dados recentes na base de dados MEDLINE, e também usando a ferramenta Google. Síntese dos dados:Existem vários possíveis agentes etiológicos envolvidos, incluindo vírus, bactérias e parasitas. O tratamento deve ser voltado para a dieta, além da reposição das perdas hidroeletrolíticas, especialmente durante a fase aguda da diarreia, para evitar seu prolongamento. Na grande maioria dos episódios, os antimicrobianos não estão indicados. Por outro lado, o tratamento da diarreia persistente deve ser reforçado no sentido de evitar as intolerâncias alimentares e a desnutrição. Conclusões:O estímulo ao aleitamento materno, a introdução de estratégias alimentares seguras no sentido de evitar a desnutrição proteico-calórica, a abordagem adequada do episódio agudo e a melhoria das condições sanitárias e de higiene são medidas a serem estimuladas com o objetivo de diminuir a morbimortalidade pela doença diarreica em crianças menores de 5 anos de idade ao redor do mundo.J Pediatr (Rio J). 2011;87(3):199-205: Desnutrição, morbidade, mortalidade, diarreia, hipersensibilidade alimentar, aleitamento materno.

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Microsporidiosis and Malnutrition in Children with Persistent Diarrhea, Uganda

Cited by 31 publications

References 12 publications

Molecular Epidemiologic Characterization of Enterocytozoon bieneusi in HIV-Infected Persons in Benin City, Nigeria

Molecular Epidemiologic Characterization of Enterocytozoon bieneusi in HIV-Infected Persons in Benin City, Nigeria

Genetic Polymorphism and Zoonotic Potential of Enterocytozoon bieneusi from Nonhuman Primates in China

Persistent diarrhea: still an important challenge for the pediatrician

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