Cryptosporidiosis among immunocompromised patients in Saudi Arabia

Area of Science:

• Medical Parasitology
• Infectious Diseases
• Immunocompromised Host Research

Background:

• Cryptosporidium infection poses a significant risk to immunocompromised individuals.
• Data on cryptosporidiosis prevalence in Saudi Arabia's immunocompromised population is limited.
• Understanding transmission dynamics is crucial for public health interventions.

Purpose of the Study:

• To determine the prevalence of Cryptosporidium infection in immunocompromised Saudi patients.
• To compare the diagnostic accuracy of Kinyoun's acid fast staining and ELISA for Cryptosporidium detection.
• To identify risk factors associated with Cryptosporidium infection in this population.

Main Methods:

• A total of 408 immunocompromised Saudi patients (age <2 to >60 years) were enrolled.
• Fecal samples were analyzed using Kinyoun's acid fast staining and a monoclonal ELISA kit.
• Demographic and clinical data were collected to assess infection rates and risk factors.

Main Results:

• Overall Cryptosporidium infection rates were 69.7% (staining) and 64.2% (ELISA).
• Microscopic examination demonstrated higher sensitivity (84.4%), specificity (81.7%), and diagnostic accuracy (83.8%) compared to ELISA.
• Higher infection rates were observed in patients receiving immunosuppressive drugs (organ transplantation, cancers), those with HIV and chronic diarrhea, and males aged 16-40 years.

Conclusions:

• Cryptosporidiosis is highly prevalent among immunocompromised Saudi patients, representing the first reported high rate.
• Microscopic examination is a more sensitive diagnostic tool than ELISA for Cryptosporidium detection in this cohort.
• The findings suggest the presence of nosocomial sources and transmission of Cryptosporidium within Saudi Arabia.