Burden of diarrhea, hospitalization and mortality due to cryptosporidial infections in Indian children.

Rajiv Sarkar,Jacqueline E Tate,Gagandeep Kang,Deepthi Kattula,Sitara S R Ajjampur,Honorine D Ward,Jacob John,Christopher D Huston

doi:10.1371/journal.pntd.0003042

Abstract

Background Cryptosporidium spp. is a common, but under-reported cause of childhood diarrhea throughout the world, especially in developing countries. A comprehensive estimate of the burden of cryptosporidiosis in resource-poor settings is not available.Methodology/Principal FindingsWe used published and unpublished studies to estimate the burden of diarrhea, hospitalization and mortality due to cryptosporidial infections in Indian children. Our estimates suggest that annually, one in every 6–11 children <2 years of age will have an episode of cryptosporidial diarrhea, 1 in every 169–633 children will be hospitalized and 1 in every 2890–7247 children will die due to cryptosporidiosis. Since there are approximately 42 million children <2 years of age in India, it is estimated that Cryptosporidium results in 3.9–7.1 million diarrheal episodes, 66.4–249.0 thousand hospitalizations, and 5.8–14.6 thousand deaths each year.Conclusions/SignificanceThe findings of this study suggest a high burden of cryptosporidiosis among children <2 years of age in India and makes a compelling case for further research on transmission and prevention modalities of Cryptosporidium spp. in India and other developing countries.

Highlights

Childhood diarrhea is one of the leading causes of morbidity and mortality throughout the world, accounting for an estimated 9.9% of the 7.6 million deaths among children,5 years of age in 2010 [1]
We combined data from community-based studies in Vellore with the national statistics for India to obtain an estimate of the cryptosporidial disease burden in Indian children
Despite the inherent challenges in generating national estimates of disease burden for a country as large and diverse as India, our study provides a useful assessment of the under-recognized burden of cryptosporidiosis in Indian children

Summary

Introduction

Childhood diarrhea is one of the leading causes of morbidity and mortality throughout the world, accounting for an estimated 9.9% of the 7.6 million deaths among children ,5 years of age in 2010 [1]. Children in developing countries are the worst affected, suffering from an average of 2.9 episodes of diarrhea per year [2], approximately one-third of which are moderate to severe [3] and result in significant morbidity that extends beyond the diarrheal episode. A better understanding of the role of specific enteric pathogens to the overall burden of diarrheal disease is essential for developing interventions that can effectively reduce the mortality and morbidity associated with diarrhea. Cryptosporidium spp. is a common, but under-reported cause of childhood diarrhea throughout the world, especially in developing countries. A comprehensive estimate of the burden of cryptosporidiosis in resource-poor settings is not available

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Conclusion