Cryptosporidiosis among children in an endemic semiurban community in southern India: does a protected drinking water
Rajiv Sarkar1, Sitara S R Ajjampur, Ashok D Prabakaran
1Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Summary
Providing bottled water did not prevent cryptosporidiosis in Indian children. This suggests cryptosporidiosis spreads through multiple pathways beyond contaminated drinking water.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Cryptosporidial infections pose a significant health risk to children in endemic communities.
- Understanding transmission routes is crucial for effective prevention strategies.
Purpose of the Study:
- To investigate if a protected water supply (bottled water) could prevent or delay cryptosporidiosis in children in an endemic Indian community.
- To assess the association between bottled water consumption and the incidence of cryptosporidiosis.
Main Methods:
- A quasi-experimental study involving 176 children in a semiurban slum in southern India.
- Children received either bottled or municipal drinking water.
- Weekly surveillance and monthly stool sample collection for Cryptosporidium testing via PCR until age two.
- Poisson survival and propensity score models were used for analysis.
Main Results:
- A high incidence of cryptosporidiosis (0.59 episodes/child-year) was observed in 67% of children, often asymptomatic.
- Stunting at 6 months was linked to increased cryptosporidiosis risk (RR=1.40).
- Bottled water consumption showed no significant reduction in cryptosporidiosis risk (adjusted RR=0.86).
Conclusions:
- A high burden of cryptosporidiosis exists among children in this Indian slum.
- The lack of association between bottled water and reduced risk suggests transmission occurs through multiple pathways, potentially including asymptomatic individuals.
- Further research into diverse transmission routes is warranted.
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