Human cryptosporidiosis and Cryptosporidium spp. in Haiti
Human cryptosporidiosis and Cryptosporidium spp. in Haiti
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DOI：
10.1111/j.1365-3156.2006.01631.x
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发表时间：
2006-06-01
影响因子：
3.3
通讯作者：
Pape, Jean W.
中科院分区：
文献类型：
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作者：
Raccurt, Christian P.;Brasseur, Philippe;Pape, Jean W.
水源传染病的污染与城市贫民窟的状况密切相关，例如过度拥挤以及动物和人类排泄物造成的高水平粪便污染。在这种环境下，隐孢子虫病是儿童急性腹泻和艾滋病患者慢性持续性腹泻的主要原因，导致这两个人群的发病率和死亡率增加。这项在海地太子港进行的研究的目的是：（i）确定两个腹泻患者、儿童和艾滋病患者人群中隐孢子虫感染的频率，以及与他们密切接触的健康成年人中是否存在隐孢子虫携带； (ii) 对所涉及的隐孢子虫物种进行 h 分子基因分型； (iii) 评估从人类工具中分离出的隐孢子虫卵囊的活力。 2000年1月至2001年1月，从93名腹泻患者、GHESKIO中心跟踪的57名成人和太子港大学医院收治的36名儿童收集的1529份腹泻粪便样本中，158份含有隐孢子虫卵囊（10.3%）。大多数成年患者（98%）感染了艾滋病毒，而大多数儿童（81%）艾滋病毒检测呈阴性。仅 1/102 的健康人在与隐孢子虫、隐孢子虫感染患者接触过的健康人中发现了隐孢子虫，并且感染的基因型与接触患者的基因型相同。在用于基因分型研究的 61 种隐孢子虫分离株中，鉴定出三个物种：人隐孢子虫 (59%)、小隐孢子虫 (38%) 和毛毡隐孢子虫 (3%)。这两起 C. 毛毡病例是加勒比地区艾滋病患者中首次报道的病例。大多数儿童，无论其艾滋病毒感染状况如何，都感染了人型 C. 毛毡菌 (72%)，而艾滋病患者更有可能被人类或动物基因型感染。这些数据证实，免疫功能低下的个体容易感染多种隐孢子虫。在实验小鼠模型中测定了隐孢子虫卵囊的活力，研究对象为 17/18 样本，包括 12/13 人隐孢子虫、4/4 隐孢子虫和 1/1 隐孢子虫。研究发现，新生小鼠的感染力具有剂量依赖性，并且与其他两种基因型相比，C. pari,son 更有效。由于卫生条件差，特别是水污染和城市贫民窟的过度拥挤，隐孢子虫病仍然是海地艾滋病患者和幼儿的常见危害。
Contamination by water-born infectious diseases is closely linked to urban slums conditions such as overcrowding and high level of taecal pollution by animal and human excreta. In this environment, cryptosporidiosis is a major cause of acute diarrhoea in children and chronic persistent diarrhoea in AIDS patients, resulting in increased morbidity and mortality in both populations. The aims of this study conducted in Port-au-Prince, Haiti were to: (i) determine the frequency of Cryptosporidium infection in two populations of patients with diarrhoea, children and AIDs patients, and the existence of Cryptosporidium carriage in healthy adults living in close contact with them; (ii) identify h molecular genotyping the Cryptosporidium species involved; and (iii) evaluate the viability of Cryptosporidium oocysts isolated from human tools. From January 2000 to January 2001, 158 of 1529 diarrhoea stool samples collected from 93 patients with diarrhoea, 57 adults followed at Centres GHESKIO and 36 children admitted at the University Hospital in Port-au-Prince contained Cryptosporidium oocysts (10.3%). The majority of adult patients (98%) were HIV-infected whereas the majority of children (81%) tested negative for HIV. Cryptosporidium was documented in only 1/102 healthy persons living in contact with Cryptos, P poridium infected patients and infection was with the same genotype as that of the contact patient. Among the 61) Criptosporidium isolates studied for genotyping, three species were identified: C. hominis (59%), C. Parvum (38%) and C. felts (3%). The two C. felts case, are the first reported from AIDS patients in the Caribbean, Most of the children regardless of their HIV status were infected with C. hominis, (72%), whereas AIDS patients were more likely to be infected by either human or animal genotypes. These data confirm that immunocompromised individuals are susceptible to a wide range of Cryptosporidium spp. Viability of Cryptosporidium oocysts were determined in an experimental mouse model for 17/18 specimen studied including in 12/13 C. hominis, 4/4 C. parvum and 1/1 C. felts. Infectivity in newborn mice was found to be dose-dependent and more effective with C. pari,son than the other two genotypes. Cryptosporidiosis remains a frequent hazard for both AIDS patients and young children in Haiti because of poor hygiene, particularly contaminated water and overcrowded conditions associated with urban slums.