Molecular seasonal, age and gender distributions of Cryptosporidium in diarrhoeic Egyptians: distinct endemicity

Abstract

Cryptosporidiosis is a worldwide gastrointestinal disease caused by the protozoan Cryptosporidium parasite. It has a broad range of seasonal and age-related prevalence. We aimed to study the molecular prevalence and seasonality of Cryptosporidium over a period of 1 year in a cohort of Egyptian diarrhoeic patients. Stool samples were collected from 865 diarrhoeic patients attending outpatient clinics of Cairo University hospitals, from all age groups over a 12-month period, examined microscopically for faecal Cryptosporidium oocysts by the acid-fast staining method and for copro-DNA detection using nested polymerase chain reaction (nPCR) assays. PCR-positive samples were characterised molecularly by nPCR-restriction fragment length polymorphism (RFLP) to determine Cryptosporidium genotypes. Cryptosporidium copro-DNA was detected in 19.5% of the collected samples throughout the year, with a major peak in summer (August) and a small rise in spring (April). Infection was mainly C. hominis (95.8%) followed by C. parvum (3.0%), affecting all age groups, with predominance in the pre-school age group, and decrease with age. There were statistically significant associations between the detection of Cryptosporidium and season, diarrhoea, patient age and drinking water, while gender, contact with animals and presence of mucus in stool showed no association. Cryptosporidium in diarrhoeic Egyptians was of distinct endemicity, with the bi-model mostly influenced by population dynamics, with a clear high prevalence in pre-school children and predominating anthroponotic (C. hominis) transmission throughout the year. The obtained results highlight Cryptosporidium as a water contaminant and an important cause of health problems in Egypt, necessitating further studies of the risk factors.

Molecular genetic characterization of human Cryptosporidium isolates and their respective demographic, environmental and clinical manifestations in Egyptian diarrheic patients

“…The usage of human excreta as manure in crops, open defecation by children in fields and free grazing of cattle along riversides may lead to contamination of river water subsequently used to irrigate fields and for washing the harvest [64] . Most of the Cryptosporidium cases in our study were detected during summer mainly in August (10 cases), and this agreed with other studies from different regions in Egypt [26,27,36,56] . The summer seasonal diarrheal peak may coexist with the increased use of rivers, lakes, swimming pools and water parks [65] .…”

“…We found no significant association between Cryptosporidium infection and history of animal or water contact. Similarly, other reports [7,27] failed to find animal association with Cryptosporidium infection. In a recent report on occupational infection hazards in sewage workers in Alexandria, Egypt, among other protozoa Cryptosporidium rated 15.6% [60] .…”

“…In the present study, the Cryptosporidium infection rate of 5.7% recorded by microscopic examination of MZN stained smears of all fecal samples, is consistent with a previous rate of 4.6% reported from ten public hospitals in Cairo Governorate [26] . Moreover, another study done on Egyptian diarrheic children attending Cairo University hospitals reported a prevalence of 7.4% [27] . However, 37.7% and 91% were generally recorded in immunodeficient children and adult patients respectively in Egypt [28] ; as well as 33.3% in immunocompromised children in Tanta Governorate [29] and 15% in El-Sharkiya Governorate [30] .…”

Cryptosporidium and Giardia in Africa: current and future challenges

“…However, other studies from Rwanda, Malawi, Kenya and South Africa have reported a higher prevalence of cryptosporidiosis at the end of rainy seasons and beginning of the drier months [129, 130]. Studies in Egypt (North Africa) reported a peak prevalence for both Cryptosporidium and Giardia during summer (drier months) with a second peak in winter for Giardia [131, 132]. It is possible that the apparent seasonality of human disease, is reflective of different transmission pathways, hosts, and/or Cryptosporidium and Giardia species in different locations.…”

The Efficacy of Three Medicinal Plants ; Garlic , Ginger and Mirazid and a Chemical Drug Metronidazole against Cryptosporidium Parvum : Ii- Histological Changes

“…They concluded that CLD affect the immunity of the patients showed significant increase in the incidence of intestinal parasites in cases compared to controls. El-Badry et al (2015) studied the molecular prevalence and seasonality of Cryptosporidium over a period of one year in a cohort of Egyptian diarrhoeic patients. Stool samples were collected from 865 diarrhoeic patients attending outpatient clinics of Cairo University Hospitals, from all age groups over one year, examined microscopically for oocysts by the acid-fast staining method and for copro-DNA detection using nPCR.…”