Cryptosporidiosis: Prevalence, genotype analysis, and symptoms associated with infections in children in Kenya
Cryptosporidiosis: Prevalence, genotype analysis, and symptoms associated with infections in children in Kenya
复制标题
DOI：
10.4269/ajtmh.2006.75.78
复制
发表时间：
2006-07-01
影响因子：
3.3
通讯作者：
Hart, Charles A.
中科院分区：
文献类型：
--
作者：
Gatei, Wangeci;Wamae, Claire N.;Hart, Charles A.
隐孢子虫寄生虫是引起肠道疾病的主要原因，尤其是在儿童中。在肯尼亚的六个微生物实验室对提交的粪便样本进行了一项关于5岁以下儿童隐孢子虫病流行率的前瞻性调查，这些粪便样本用于常规寄生虫和卵子调查。在为期两年的研究期间对4899个样本进行的分析显示，隐孢子虫病的总体患病率为4%，在11月至2月期间最高。肠道疾病性质调查显示，66.4%为急性腹泻，9%为持续性腹泻，21%为复发性腹泻。主要症状为腹痛（51.1%）、呕吐（51.6%）、腹胀（11%）。隐孢子虫病患病率在1.3 ~ 24月龄儿童中最高（5.2%），在48 ~ 60月龄儿童中最低（2%）。性别差异无统计学意义，但男性呕吐率略高于女性（男性为65%，女性为52%；P = 0.07）。隐孢子虫病与持续性腹泻（P = 0.0001，优势比[OR] = 2.193, 95%可信区间[CI] 1.463-3.29）、呕吐（P = 0.0273, OR = 1.401, 95% CI = 1.04-1.893）和腹胀（P = 0.0311, OR 1.56, 95% CI = 1.04-2.34）显著相关。基于18S rRNA基因片段聚合酶链反应-限制性片段长度多态性的基因型分析显示，175株隐孢子虫分离物中有87%（153株）为人隐孢子虫，9%（15株）为小隐孢子虫，其余4%为犬隐孢子虫、猫隐孢子虫、meleagrids隐孢子虫和muris隐孢子虫。合并感染患者中最常见的原虫是溶组织内阿米巴原虫。大肠杆菌和肠贾第鞭毛虫（分别为6%，5%和2%）。我们的研究结果表明，隐孢子虫是儿童肠道疾病中最常见的原生动物寄生虫之一，人传物种是肯尼亚人类隐孢子虫病的主要原因，这表明人与人之间的传播是主要的传播方式。
Cryptosporidium parasites are leading causes of enteric disease, especially in children. A prospective survey on the prevalence of cryptosporidiosis in children less than five years of age was undertaken at six microbiology laboratories in Kenya on fecal samples submitted for routine parasite and ova investigations. Analysis of 4,899 samples over a two-year study period showed an overall prevalence of cryptosporidiosis of 4% that was highest between November to February. Investigations on the nature of enteric diseases prompting ova and cyst examination requests showed 66.4% had acute diarrhea, 9% had persistent diarrhea, and 21% had recurrent diarrhea. The main symptoms were abdominal pain (51.1%), vomiting (51.6%), and abdominal swelling (11%). The prevalence of cryptosporidiosis was highest among children 1.3-24 months of age (5.2%) and least among those 48-60 months of age (2%). No significant differences were observed by sex but vomiting was slightly higher in males than in females (65% males and 52% females; P = 0.07). Cryptosporidiosis was significantly associated with persistent diarrhea (P = 0.0001, odds ratio [OR] = 2.193, 95% confidence interval [CI] 1.463-3.29), vomiting (P = 0.0273, OR = 1.401, 95% CI = 1.04-1.893), and abdominal swelling (P = 0.0311, OR 1.56, 95% CI = 1.04-2.34). Genotype analysis based on polymerase chain reaction-restriction fragment length polymorphism of the 18S rRNA gene fragment showed that 87% (153 of 175) of the Cryptosporidium isolates were C. hominis, 9% (15 of 175) were C. parvum, and remaining 4% were C. canis, C. felis, C. meleagridis, and C. muris. The most common protozoa in coinfected patients were Entamoeba histolytica/E. dispar, E. coli, and Giardia intestinalis (6%, 5%, and 2%, respectively). Our results show that Cryptosporidium is among the most common protozoan parasites in children with enteric diseases and that anthroponotic species are the leading cause of human cryptosporidiosis in Kenya, which suggests that human-to-human transmission is the main mode of spread.