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[Cryptosporidiosis in humans. Review]
1Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela.
Insights
Cryptosporidiosis is a global diarrheal disease, primarily affecting young children in developing nations. Diagnosis involves detecting oocysts in stool, but effective treatments and vaccines remain elusive.
Area of Science:
- Parasitology
- Public Health
- Infectious Diseases
Context:
- Cryptosporidiosis is a significant gastrointestinal infection caused by Cryptosporidium protozoa.
- It is a major public health concern, particularly prevalent in children under five in developing countries.
- Human infection is commonly caused by Cryptosporidium parvum, transmitted via zoonotic, person-to-person, and contaminated water routes.
Purpose:
- To review the epidemiology, transmission, pathogenesis, diagnosis, and control of cryptosporidiosis.
- To highlight the challenges in managing this infection due to resistant oocysts and incomplete knowledge of transmission.
Summary:
- Cryptosporidiosis presents as diarrhea, with severity depending on host immunity; it's self-limiting in immunocompetent individuals but life-threatening in immunocompromised patients, especially those with AIDS.
- Diagnosis relies on identifying oocysts in stool using modified acid-fast, fluorescence stains, or immunofluorescent assays.
- While immunotherapy shows promise, effective treatments and vaccines are unavailable, limiting control efforts.
Impact:
- Understanding Cryptosporidium transmission and pathogenesis is crucial for developing effective prevention and treatment strategies.
- Improved diagnostic methods and potential immunotherapies offer hope for managing cryptosporidiosis.
- Addressing knowledge gaps in transmission routes and developing vaccines are essential for controlling this widespread parasitic infection.
Abstract:
Cryptosporidiosis basically is a gastrointestinal infection caused by the coccidian protozoa Cryptosporidium. The infection is associated with diarrhea worldwide but it is most prevalent among children below 5 years of age in the undeveloped countries. It is an important Public Health problem. Infection in humans is usually with C. parvum. The parasite appears to be transmitted by a variety of mechanisms but zoonotic- and person-to-person transmission, and contaminated water appear to be the most important. The mechanism by which the coccidium causes diarrhea is unknown. The extent of the disease is mostly dependent on the immune status of the host. In immunocompetent persons, C. parvum may cause a short term diarrheal disease that resolves spontaneously; in immunocompromised patients, especially those with AIDS, produces a prolonged, life-threatening cholera-like disease. The diagnosis is generally made by detection of oocysts in stools by means of several concentration and staining procedures. Modified acid-fast and fluorescence stains are widely used. Immunofluorescent assays with Cryptosporidium-clonal antibodies have been developed to detect oocysts in stool specimens. Specific humoral antibodies have been detected by immunofluorescence and enzyme-linked immunosorbent assay techniques. Although an effective agent for Cryptosporidium is not available yet, promising results have been related to the immunotherapy. Vaccines are not available and the control and prevention of the infection is limited because of the environmentally resistant oocysts and the ignorance of all its possible transmission routes.