Cryptosporidium and Cyclospora Diarrheal Infection in Malnourished Children: a Nutritional Approach

Abstract

Over two million children under 5 years of age die each year in developing countries because of acute diarrhea. Cyclospora and Cryptosporidium are parasites recognized as a major cause of diarrhea in children and immunocompromised patients. The clinical expression of the parasites, however, is mainly determined by host defenses, and when they are weakened, parasitic diarrhea is frequent and severe. Protein-energy malnutrition is by far the most important cause of immune deficiency in developing countries. The purpose of this review is to consolidate the main nutritional interventions in malnourished children in developing countries with diarrheal infection by Cyclospora and Cryptosporidium. Higher isolation rate of Cryptosporidium and Cyclospora is seen among malnourished children. Cryptosporidium is a second leading cause of moderate-to-severe diarrhea in infants according to GEMS study. We review the etiology and characteristics of Cryptosporidium and Cyclospora and the consequences of diarrhea in children under five, especially those with malnutrition and other risk factors. The main interventions to treat these pathogen diarrheal infections include antibiotics and antiparasitic agents, oral rehydration, zinc supplementation, and dietary modifications. Prevention strategies include safe water, sanitation, hygiene, and breastfeeding.