Cryptosporidium parvum in children with diarrhea in Mulago Hospital, Kampala, Uganda
Cryptosporidium parvum in children with diarrhea in Mulago Hospital, Kampala, Uganda
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DOI：
10.4269/ajtmh.2003.68.710
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发表时间：
2003-06-01
影响因子：
3.3
通讯作者：
Tzipori, S
中科院分区：
文献类型：
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作者：
Tumwine, JK;Kekitiinwa, A;Tzipori, S
在乌干达坎帕拉的Mulago医院进行了一项为期15个月的横断面病例对照研究（比例=3：1），以确定隐孢子虫病在住院腹泻儿童（0-5岁）中的患病率和后果。在2，446名儿童中检测到隐孢子虫并进行基因分型，其中1，779名（72.7%）患有腹泻，667名（27.3%）为年龄和性别匹配的对照。在1,779名腹泻儿童中，532名（29.9%）为持续性腹泻（>14天），1,247名（70.1%）为急性腹泻。总的来说，1,779例腹泻患儿中有444例（25.0%）感染了小隐孢子虫，而667例无腹泻患儿中只有57例（8.5%）感染了小隐孢子虫（χ 2 =80.2，P <0.0001）。在这组感染儿童中，72.8%为基因型1感染，18.4%为基因型2感染，4.1%为两种基因型的混合感染，4.1%的分离株为未分类或C。meleagridis.在4月至6月的多雨月份，感染率最高。532例持续性腹泻患儿中166例（31.2%）有微小隐孢子虫感染，1,247例急性腹泻患儿中278例（22.3%）有微小隐孢子虫感染（χ 2 =15.8，P <0.0001）。C.矮小和营养不良，包括发育迟缓、体重不足和消瘦。191例C型肝炎患儿中有139例（72.8%）发生不良结局（死亡或14天内未能缓解）。在545例无C. parvum感染的儿童中，C. parvum感染率为65.1%（OR =1.117，95%可信区间=1.005-1.243，P=0.05）。545例无C. parvum感染者中，死亡24例（12.6%），死亡34例（6.2%）。P=0.005。在严重脱水和持续腹泻的儿童中，以及在感染C.小的在乌干达儿童中，隐孢子虫病仍然无法治疗，经常与腹泻和其他严重和不利的后果有关。
A cross-sectional case-control study (ratio=3:1) was conducted over a 15-month period to determine the prevalence and consequences of cryptosporidiosis in hospitalized diarrheic children (0-5 years old) at Mulago Hospital in Kampala, Uganda. Cryptosporidium parvum was detected and genotyped among 2,446 children of whom 1,779 (72.7%) had diarrhea, and 667 (27.3%) were age- and sex-matched controls. Of the 1,779 children with diarrhea, 532 (29.9%) had persistent (>14 days) diarrhea and 1,247 (70.1%) had acute diarrhea. Overall, 444 (25.0%) of the 1,779 children with diarrhea had C parvum, compared with only 57 (8.5%) of the 667 children without diarrhea (chi(2)=80.2, Pless than or equal to0.0001). Within this group of infected children, 72.8% were infected with genotype 1, 18.4% with genotype 2, and 4.1% with a mixture of both genotypes, and 4.1% isolates were either unclassified or C. meleagridis. The prevalence was highest during the rainy months of April to June. Of the 532 children with persistent diarrhea, 166 (31.2%) had C parvum compared with 278 (22.3%) of the 1,247 children with acute diarrhea (chi(2)=15.8, Pless than or equal to0.0001). There was a significant association between C. parvum and malnutrition including stunting, being underweight, and wasting. Unfavorable outcome (death or failure to resolve within 14 days) occurred in 139 (72.8%) of the 191 children with C. parvum, and in only 65.1% of the 545 without (odds ratio=1.117, 95% confidence interval=1.005-1.243, P=0.05), Of the 191 children with C. parvum, 24 (12.6%) died, compared with 34 (6.2%) of the 545 without C. parvum (P=0.005). Mortality rates were higher among children with severe dehydration and persistent diarrhea, and in stunted or underweight children infected with C. parvum. Among Ugandan children, cryptosporidiosis, which remains untreatable, is frequently associated with diarrhea and other serious and unfavorable consequences.