High Frequency of Cryptosporidium hominis Infecting Infants Points to A Potential Anthroponotic Transmission in Maputo, Mozambique.

Idalécia Cossa-Moiane,Elda Anapakala,Marta Cassocera,Assucênio Chissaque,Esperança Lourenço Guimarães,Jorfélia Chilaúle,Maria Fantinatti,Lena Vânia Manhique-Coutinho,Jerónimo Souzinho Langa,Júlia Sambo,Diocreciano Matias Bero,Hermínio Cossa,Luis António Lopes-Oliveira,Miguel Bambo,Nilsa De Deus,Alda Maria Da-Cruz,Adilson Fernando Loforte Bauhofer

doi:10.3390/pathogens10030293

Abstract

Cryptosporidium is one of the most important causes of diarrhea in children less than 2 years of age. In this study, we report the frequency, risk factors and species of Cryptosporidium detected by molecular diagnostic methods in children admitted to two public hospitals in Maputo City, Mozambique. We studied 319 patients under the age of five years who were admitted due to diarrhea between April 2015 and February 2016. Single stool samples were examined for the presence of Cryptosporidium spp. oocysts, microscopically by using a Modified Ziehl–Neelsen (mZN) staining method and by using Polymerase Chain Reaction and Restriction Fragment Length Polymorphism (PCR-RFLP) technique using 18S ribosomal RNA gene as a target. Overall, 57.7% (184/319) were males, the median age (Interquartile range, IQR) was 11.0 (7–15) months. Cryptosporidium spp. oocysts were detected in 11.0% (35/319) by microscopy and in 35.4% (68/192) using PCR-RFLP. The most affected age group were children older than two years, [adjusted odds ratio (aOR): 5.861; 95% confidence interval (CI): 1.532–22.417; p-value < 0.05]. Children with illiterate caregivers had higher risk of infection (aOR: 1.688; 95% CI: 1.001–2.845; p-value < 0.05). An anthroponotic species C. hominis was found in 93.0% (27/29) of samples. Our findings demonstrated that cryptosporidiosis in children with diarrhea might be caused by anthroponomic transmission.

Highlights

Diarrhea is the one main causes of mortality among children less than 5 years old in low and middle-income countries (LMIC) [1,2]
Those studies indicate lower frequencies of Cryptosporidium spp. if we consider our Polymerase Chain Reaction (PCR) results (35.4%): 12% in children hospitalized with diarrhea by using ELISA [17], 3.4% in children admitted in pediatric ward in one north central hospital by using modified Ziehl–Neelsen (mZN) and rapid test [18] and 34% in children from ViNaDiA
This study showed a high frequency of Cryptosporidium spp. infection detected by PCR-RFLP among children admitted to two public hospitals in Maputo City due to acute diarrhea

Summary

Introduction

Diarrhea is the one main causes of mortality among children less than 5 years old in low and middle-income countries (LMIC) [1,2]. Cryptosporidium spp. is an apicomplexan enteric pathogenic parasite protozoan related to water and foodborne outbreaks worldwide [4,5,6,7]. It spreads in the environment, through soil, drinking and recreation water (swimming pool, surface waters) or even directly by person-to-person contact and contact with objects surfaces with oocysts [4]. Cryptosporidium is considered an opportunistic parasite that can infect immunocompetent and immunocompromised people [8] It can infect wild and domestic animals [4,9,10], which facilitates spread in the environment

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