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Cryptosporidium infections in Mexican children: clinical, nutritional, enteropathogenic, and diagnostic evaluations
F Javier Enriquez1, C R Avila, J Ignacio Santos
1Department of Veterinary Science, University of Arizona, Tucson, USA.
Insights
Cryptosporidiosis affected 6.4% of young children with diarrhea in Mexico City. Malnourished infants and those not breastfed were at higher risk for this infection.
Area of Science:
- Pediatric Infectious Diseases
- Parasitology
- Public Health
Background:
- Cryptosporidiosis is a significant cause of diarrheal disease in young children globally.
- Understanding its prevalence and risk factors in specific populations is crucial for effective public health interventions.
Purpose of the Study:
- To determine the prevalence of cryptosporidiosis in children under five with acute diarrhea in Mexico City.
- To identify risk factors associated with Cryptosporidium parvum infection.
- To compare the diagnostic accuracy of immunofluorescence and acid-fast techniques.
Main Methods:
- An indirect immunofluorescence assay was used on stool samples from 403 children.
- Data on clinical manifestations, dwelling characteristics, and feeding practices were collected.
- Enteropathogenic bacteria and HIV antibodies were also screened.
Main Results:
- A 6.4% prevalence of cryptosporidiosis was observed, peaking during summer months.
- Infection was more common in infants under one year, malnourished children, and non-breastfed infants.
- Monoclonal antibody-based immunofluorescence demonstrated higher diagnostic accuracy than the acid-fast technique.
Conclusions:
- Cryptosporidiosis prevalence in this cohort is comparable to other developing countries.
- Malnutrition and lack of breastfeeding are significant risk factors for C. parvum infection in infants.
- Monoclonal antibody-based immunofluorescence is a superior diagnostic method for cryptosporidiosis.
Abstract:
Using an indirect immunofluorescence assay on stool samples, we found a 6.4% prevalence of cryptosporidiosis among 403 children less than five years of age with acute diarrhea in Mexico City over a one-year period. The prevalence was highest (11.4%) during the rainy summer months. Most Cryptosporidium parvum cases occurred in infants less than one year of age. Cryptosporidium parvum was more common in malnourished children (P < 0.05) and in nonbreast-fed infants less than six months of age (P < 0.01). Neither dwelling characteristics nor the presence of domestic animals at home were associated with C. parvum infection. Enteropathogenic bacteria were found in 26.8% of the children; Escherichia coli, Salmonella, and Shigella being the most frequently identified. None of 100 serum samples tested showed antibodies against human immunodeficiency virus. When compared with immunofluorescence, the acid-fast technique showed a sensitivity of 76.9% and a specificity of 98.9%, with a predictive positive value of 83.3%. It was concluded that 1) monoclonal antibody-based immunofluorescence is a better diagnostic tool than the acid-fast technique, 2) the prevalence of cryptosporidiosis in this population was similar to that of other developing countries, 3) clinical manifestations were nonspecific, and 4) C. parvum was more common in malnourished children and in nonbreast-fed infants.