Cryptosproridiosis and microsporidiosis in Ugandan children with persistent diarrhea with and without concurrent infection with the Human Immunodeficiency Virus

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dc.creatorTumwine, James K.
dc.creatorKekitiinwa, Addy
dc.creatorBakeera-Kitaka, Sabrina
dc.creatorNdeezi, Grace
dc.creatorDowning, Robert
dc.creatorFeng, Xiaochuan
dc.creatorAkiyoshi, Donna E.
dc.creatorTzipori, Saul
dc.date2013-02-04T08:20:07Z
dc.date2013-02-04T08:20:07Z
dc.date2005
dc.date.accessioned2018-09-04T12:32:31Z
dc.date.available2018-09-04T12:32:31Z
dc.description© 2005 The American Society of Tropical Medicine and Hygiene. This article is available from: http://www.ajtmh.org/
dc.descriptionCryptosporidium spp. and Enterocytozoon bieneusi are enteric pathogens that have emerged as significant causes of persistent diarrhea (PD) in immunologically compromised individuals particularly in association with HIV/AIDS. We conducted a cross-sectional study on the clinical epidemiology of E. bieneusi and Cryptosporidium in children with PD, with and without HIV/AIDS, attending Uganda’s Mulago National Referral Hospital. Two hundred forty-three children aged < 60 months, admitted between November 2002 and May 2003 with PD (> 14 days), were analyzed for HIV status and CD4 lymphocyte counts, and stools were screened for the presence of E. bieneusi and Cryptosporidium by microscopy and positive samples genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Eighty (32.9%) of the children were excreting E. bieneusi, and 76 (31.3%) were excreting Cryptosporidium. Ninety-one of the 243 children had HIV, of who 70 (76.9%) had E. bieneusi, versus 10 (6.6%) of the 152 without (odds ratio = 47.33; 95% CI = 19.88 to 115.97), while 67 (73.6%) had Cryptosporidium, versus 9 (5.9%) without (odds ratio = 44.36; 95% CI = 18.39 to 110.40). Children with counts < 25% CD4 cells were more likely to have either E. bieneusi (odds ratio = 7.42; 95% CI = 3.77 to 14.69) or Cryptosporidium (odds ratio = 6.45; 95% CI = 3.28 to 12.76) than those with higher CD4 percentages. However, only HIV status was independently associated with either Cryptosporidium or E. bieneusi. Among the 243 children with PD, 67 (27.8%) were infected with both enteric pathogens, with HIV being the only independent predictor of coinfection. Finally, some 81% of HIV-infected children with PD excreted one or both organisms, compared with only 10% of children with PD testing negative for HIV. Seventy-four percent of isolates were C. hominis, the anthroponotic species, 17% were C. parvum, the zoonotic species, and 8% were a mixture of the two or others.
dc.identifierAmerican Journal of Tropical Medicine and Hygiene, 2005, 73(5): 921-925
dc.identifier0002-9637
dc.identifierhttp://www.ajtmh.org/
dc.identifier
dc.identifierhttp://hdl.handle.net/10570/1033
dc.identifier.urihttp://hdl.handle.net/10570/1033
dc.languageen
dc.publisherAmerican Society of Tropical Medicine and Hygiene
dc.subjectDiarrhea
dc.subjectHIV/AIDS
dc.subjectChildren Uganda
dc.titleCryptosproridiosis and microsporidiosis in Ugandan children with persistent diarrhea with and without concurrent infection with the Human Immunodeficiency Virus
dc.typeJournal article, peer reviewed
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