Abstract
BackgroundIntestinal parasites such as Cryptosporidium spp., Giardia lamblia and Entamoeba histolytica can cause severe diarrhea, especially among children in developing countries. This study aims to determine the frequency of Cryptosporidium spp., Giardia lamblia and Entamoeba histolytica in children with diarrhea and identify risk factors for infection.MethodologyWe conducted a cross-sectional study in children aged 0–168 months hospitalized with diarrhea in three regions of Mozambique, from June 2014 to January 2018. Following consent, caretakers were interviewed and a single stool specimen was collected from each child to diagnose Cryptosporidium spp., G. lamblia and E. histolytica using commercial immune-enzymatic assay (TechLab, Inc, Blacksburg, VA, USA). Anthropometric data were collected from the clinical reports. Multivariable logistic regression models were built to identify risk factors for Cryptosporidium spp. and G. lamblia infection.ResultsTwenty-one percent of all specimens (212/1008) presented at least one parasitic infection. Cryptosporidium spp. infection was the most common 12.0% (118/985), followed by G. lamblia 9.7% (95/983) and E. histolytica 2.0% (20/1004). Risk factors for infection by Cryptosporidium spp. were: provenience (children from Nampula province showed the highest risk, OR: 8.176; CI: 1.916–34.894; p-value < 0.01); animal contact (children with animal contact had a protective effect OR: 0.627; CI: 0.398–0.986; p-value < 0.05); underweight (children severely underweight showed a risk of 2.309; CI: 1.310–4.069; p-value < 0.05). Risk factors for infection by G. lamblia were: age (group with highest risk, 60–168 months (OR: 2.322; CI: 1.000–5.393, p-value > 0.05)); and living in a household with five or more members (OR: 2.141; CI: 1.286–3.565, p-value < 0.01).ConclusionsParasitic infection is common among children with diarrhea. Routine testing, standard treatment, and assessment for risk exposure of children with diarrhea should be implemented at health facilities in Mozambique.
Highlights
6.3 million children (0–168 months) died in 2017, most of which were under five years old (5.4 million)
Parasitic infection is common among children with diarrhea
Standard treatment, and assessment for risk exposure of children with diarrhea should be implemented at health facilities in Mozambique
Summary
6.3 million children (0–168 months) died in 2017, most of which were under five years old (5.4 million). Sub-Saharan Africa has the highest under-five mortality rate in the world, having one death in every 13 births [1]. In Mozambique, the under-five mortality is estimated to be between 50 to 70 deaths per 1000 births [1]. Diarrhea accounts globally for approximately 8% (432000) of all deaths in children less than five years old [1]. Cryptosporidium spp. is most common in children with diarrhea, followed by Giardia lamblia and Entamoeba histolytica [2,3,4,5,6]. This study aims to determine the frequency of Cryptosporidium spp., Giardia lamblia and Entamoeba histolytica in children with diarrhea and identify risk factors for infection
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