Cryptosporidiosis among Bangladeshi children with diarrhea: A prospective, matched, case-control study of clinical features, epidemiology and systemic antibody responses
Cryptosporidiosis among Bangladeshi children with diarrhea: A prospective, matched, case-control study of clinical features, epidemiology and systemic antibody responses
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DOI：
10.4269/ajtmh.2004.71.412
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发表时间：
2004-10-01
影响因子：
3.3
通讯作者：
Ward, HD
中科院分区：
文献类型：
--
作者：
Khan, WA;Rogers, KA;Ward, HD
我们进行了一项前瞻性病例对照研究，以调查孟加拉国儿童隐孢子虫病的流行病学、临床特征和全身抗体反应。 46 名患有腹泻和隐孢子虫病的儿童前往位于孟加拉国达卡的孟加拉国国际腹泻病研究中心就诊。粪便中的卵囊作为病例登记。 46 名年龄匹配的腹泻儿童作为对照，但没有隐孢子虫感染。 30 例病例和 23 名对照者在出院三周后返回进行随访。隐孢子虫属感染。最常见于两岁以下儿童，伴有水样腹泻和呕吐，更有可能伴有持续性腹泻。除了腹泻持续时间外，病例和对照之间的临床或流行病学特征没有显着差异。与就诊时的对照相比，病例中隐孢子虫特异性血清 IgM 水平显着升高。此外，在三周的随访期内，与对照组相比，病例的血清隐孢子虫特异性血清 IgG 水平显着增加。在病例组内，急性和持续性腹泻儿童在随访期间的 IgG 水平变化没有差异。然而，急性和持续性腹泻儿童的 IgA 和 IgM 水平变化存在显着差异，持续性腹泻与两种抗体水平下降有关。
We conducted a prospective case-control study to investigate the epidemiology, clinical features, and systemic antibody responses of cryptosporidiosis in Bangladeshi children. Forty-six children presenting to the International Center for Diarrheal Disease Research, Bangladesh in Dhaka, Bangladesh with diarrhea and Cryptosporidium spp. oocysts in the stool were enrolled as cases. Forty-six age-matched children with diarrhea, but without cryptosporidial infection, were enrolled as controls. Thirty cases and 23 controls returned for follow-up three weeks after discharge. Infection with Cryptosporidium spp. occurred most commonly in those less than two years of age, was accompanied by watery diarrhea and vomiting, and was more likely to be associated with persistent diarrhea. Other than duration of diarrhea, there were no significant differences in clinical or epidemiologic features between cases and controls. Cryptosporidium-specific serum IgM levels were significantly higher in cases compared with controls at presentation. In addition, there was a significant increase in serum Cryptosporidium-specific serum IgG levels over the three-week follow-up period in cases compared with controls. Within the case group, there was no difference between children with acute and persistent diarrhea in the change in IgG levels over the follow-up period. However, there was a significant difference between children with acute and persistent diarrhea in changes in both IgA and IgM levels, with persistent diarrhea being associated with a decrease in levels of both antibodies.