Cryptosporidium species and subtypes in diarrheal children and HIV-infected persons in Ebonyi and Nsukka, Nigeria

Lihua Xiao,Boniface Nwofoke Ukwah,Dawn Roellig,Ifeoma Maureen Ezeonu,Chinonyelum Thecla Ezeonu

doi:10.3855/jidc.8034

Abstract

Cryptosporidiosis is a common disease of children and immune-compromised persons. This study evaluated the diversity and distribution of Cryptosporidium species in diarrheal children and HIV-infected persons on highly active antiretroviral therapy (HAART) and those not on HAART. A total of 394 fecal specimens were collected from patients attending clinics in Nsukka and Ebonyi, Nigeria. Detection and identification of Cryptosporidium species were conducted by PCR-RFLP of the small subunit (SSU) rRNA gene, whereas subtyping was done by sequence analysis of the 60 kDa glycoprotein (gp60) gene. Twenty-five (6.3%) specimens yielded four Cryptosporidium species, including C. hominis, C. parvum, C. felis, and C. viatorum. C. hominis was the most dominant species with 48.0% occurrence and three identified subtype families: Ia (six specimens), Ib (three specimens), Ie (two specimens), and one un-subtyped species. C. parvum had 44.0% occurrence and two subtype families: IIc (eight specimens) and IIe (three specimens), while C. felis and C. viatorum each had 4.0% occurrence. There were significant differences in Cryptosporidium species distribution between age groups in children and HIV-infected persons, between suburban and urban areas, and between low and high CD4+ cell counts in HIV-infected patients. There were no significant differences in infection rate and species distribution between HIV-infected patients on HAART and those not on HAART. The results from this study show that there is a high diversity of Cryptosporidium spp. in humans in Ebonyi and Nsukka, Nigeria, and that all the C. parvum subtypes identified are most likely anthroponotic in origin.

Highlights

Cryptosporidiosis is a common disease of children and immune-compromised persons
The results showed relatively high rates of Cryptosporidium infection in diarrheal children and HIV-infected persons in Ebonyi and Nsukka, southeastern Nigeria, with a significantly (p < 0.05) higher infection rate in Ebonyi (7.8%) than in Nsukka (3.7%)
The difference in Cryptosporidium infection rate between Ebonyi and Nsukka is probably due to the fact that residents of Ebonyi have more frequent contact with bodies of water, such as streams and rivers, which are commonly contaminated by sewage and domestic wastewater, as transmission of Cryptosporidium spp. is often associated with human and animal fecal contamination of water sources [3,1720]

Summary

Introduction

Cryptosporidiosis is a common disease of children and immune-compromised persons. This study evaluated the diversity and distribution of Cryptosporidium species in diarrheal children and HIV-infected persons on highly active antiretroviral therapy (HAART) and those not on HAART. Detection and identification of Cryptosporidium species were conducted by PCR-RFLP of the small subunit (SSU) rRNA gene, whereas subtyping was done by sequence analysis of the 60 kDa glycoprotein (gp60) gene. Genotyping and subtyping of Cryptosporidium species are done mostly by polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP) analysis of the small subunit (SSU) rRNA gene and the sequencing of the 60 kDa glycoprotein gene (gp). Genotyping and subtyping of Cryptosporidium species are done mostly by polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP) analysis of the small subunit (SSU) rRNA gene and the sequencing of the 60 kDa glycoprotein gene (gp60) This has led to identification of about 20 Cryptosporidium species and genotypes in humans, including C. parvum, C. hominis, C. meleagridis, C. canis, C. felis, and the recently identified C. viatorum. These Cryptosporidium species have been found in both HIV+ patients and children

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Discussion

Conclusion