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High Frequency of Cryptosporidium hominis Infecting Infants Points to A Potential Anthroponotic Transmission in
Idalécia Cossa-Moiane1,2, Hermínio Cossa3, Adilson Fernando Loforte Bauhofer1,4
1Instituto Nacional de Saúde (INS), EN1, Bairro da Vila-Parcela n° 3943, Distrito de Marracuene, Maputo 264, Mozambique.
Abstract:
Cryptosporidium is one of the most important causes of diarrhea in children less than 2 years of age. In this study, we report the frequency, risk factors and species of Cryptosporidium detected by molecular diagnostic methods in children admitted to two public hospitals in Maputo City, Mozambique. We studied 319 patients under the age of five years who were admitted due to diarrhea between April 2015 and February 2016. Single stool samples were examined for the presence of Cryptosporidium spp. oocysts, microscopically by using a Modified Ziehl-Neelsen (mZN) staining method and by using Polymerase Chain Reaction and Restriction Fragment Length Polymorphism (PCR-RFLP) technique using 18S ribosomal RNA gene as a target. Overall, 57.7% (184/319) were males, the median age (Interquartile range, IQR) was 11.0 (7-15) months. Cryptosporidium spp. oocysts were detected in 11.0% (35/319) by microscopy and in 35.4% (68/192) using PCR-RFLP. The most affected age group were children older than two years, [adjusted odds ratio (aOR): 5.861; 95% confidence interval (CI): 1.532-22.417; p-value < 0.05]. Children with illiterate caregivers had higher risk of infection (aOR: 1.688; 95% CI: 1.001-2.845; p-value < 0.05). An anthroponotic species C. hominis was found in 93.0% (27/29) of samples. Our findings demonstrated that cryptosporidiosis in children with diarrhea might be caused by anthroponomic transmission.
Insights
Cryptosporidium infection is common in Mozambican children with diarrhea. Molecular methods detected higher rates, with older children and those with illiterate caregivers at increased risk, suggesting human-to-human transmission.
Area of Science:
- Medical Parasitology
- Molecular Diagnostics
- Pediatric Infectious Diseases
Background:
- Cryptosporidium is a significant cause of childhood diarrhea globally.
- Understanding its prevalence and transmission in specific regions like Maputo, Mozambique is crucial for public health interventions.
Purpose of the Study:
- To determine the frequency, risk factors, and species of Cryptosporidium in children with diarrhea in Maputo.
- To compare molecular diagnostic methods with microscopy for Cryptosporidium detection.
Main Methods:
- A study involving 319 children under five with diarrhea admitted to Maputo hospitals.
- Stool samples analyzed using Modified Ziehl-Neelsen (mZN) staining and Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) targeting the 18S rRNA gene.
Main Results:
- Cryptosporidium was detected in 11.0% by microscopy and 35.4% by PCR-RFLP.
- Children over two years old and those with illiterate caregivers showed significantly higher infection risks.
- The predominant species identified was Cryptosporidium hominis (93.0%), indicating anthroponotic transmission.
Conclusions:
- Molecular methods like PCR-RFLP are more sensitive for detecting Cryptosporidium than microscopy.
- Risk factors for cryptosporidiosis in this population include age and caregiver literacy.
- The findings suggest that anthroponotic transmission is a major driver of cryptosporidiosis in children with diarrhea in Maputo.
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