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Molecular epidemiology of Cryptosporidium spp. in North Lebanon
Marwan Osman1, Sadia Benamrouz2, Karine Guyot2
1Ecole Doctorale des Sciences et de Technologie, Faculté de Santé Publique, Université Libanaise, Tripoli, Liban. marwan.osman@outlook.com.
Abstract:
Cryptosporidium spp. are enteroparasites with worldwide distribution that infect the gastrointestinal tract of several vertebrates including humans. Human to human, zoonotic, foodborne and waterborne are reported as the main transmission routes of this parasite. Cryptosporidium spp. have been recognized as the predominant cause of waterborne and foodborne outbreaks. However, the epidemiological situation of cryptosporidiosis is not well known in Lebanon, a developing country with a population often affected by intestinal parasitic infections. This study was devoted to determine the prevalence and the genetic diversity of Cryptosporidium spp. in symptomatic hospitalized patients and in two children populations with different socio-economic level in North-Lebanon, as well as the risk factors associated with cryptosporidiosis. Fecal samples obtained from these populations were examined microscopically by modified Ziehl-Neelsen staining as well as nested PCR were done for the detection of Cryptosporidium oocysts. Out of 163 symptomatic hospitalized patients and 249 children, Cryptosporidium was present in 11% and 10.4% respectively according to microscopy examination and/or molecular tests. The genotyping showed the predominance of Cryptosporidium hominis in both populations. Subgenotype analysis of the isolates at the gp60 locus identified three subtypes IdA19, IbA10G2 and IaA18R3 for C. hominis and two subtypes IIaA15G1R1 and IIaA15G2R1 for C. parvum. Moreover, cryptosporidiosis was correlated with having meals outside home and presence of gastrointestinal symptoms especially diarrhea (p <0.05). This work constitutes the first molecular epidemiology study outlining risk factors associated with cryptosporidiosis in Lebanon. These findings support a need of a control program to prevent the circulation of this parasite.
Insights
This study investigated Cryptosporidium parasite infections in Lebanon, finding it prevalent in hospitalized patients and children. The research identified common Cryptosporidium species and risk factors like eating out and diarrhea.
Area of Science:
- Medical Parasitology
- Molecular Epidemiology
- Public Health
Background:
- Cryptosporidium spp. are globally distributed enteroparasites causing significant gastrointestinal illness in humans and animals.
- Waterborne and foodborne transmission are primary routes, leading to frequent outbreaks worldwide.
- The epidemiology and genetic diversity of Cryptosporidium in Lebanon remain largely uncharacterized.
Purpose of the Study:
- To determine the prevalence and genetic diversity of Cryptosporidium species in symptomatic patients and children in North Lebanon.
- To identify risk factors associated with cryptosporidiosis in these populations.
- To provide molecular data for public health interventions in Lebanon.
Main Methods:
- Microscopic examination of fecal samples using modified Ziehl-Neelsen staining.
- Molecular detection and genotyping of Cryptosporidium using nested PCR.
- Subtyping of isolates at the gp60 locus for detailed genetic analysis.
Main Results:
- Prevalence of Cryptosporidium was 11% in hospitalized patients and 10.4% in children.
- Cryptosporidium hominis was the predominant species identified.
- Key risk factors included eating meals outside the home and experiencing gastrointestinal symptoms, particularly diarrhea.
Conclusions:
- This study provides the first molecular epidemiological data on cryptosporidiosis in Lebanon.
- Findings highlight the circulation of specific Cryptosporidium hominis and C. parvum subtypes.
- Results underscore the need for targeted control programs to mitigate parasite transmission in Lebanon.
