Abstract
BackgroundDocument seasonality occurrence and epidemiologic characteristics of Cyclospora cayetanensis infections during a 10-year period from patients consulting at the University Hospital, Honduras.MethodsRetrospective non interventional hospital-based study analyzed laboratory results from the period 2002 to 2011 of fresh and Ziehl-Nielsen carbolfuchsin stained routine stool samples received for parasitologic examination. Sporadically a sample with numerous oocysts was allowed to sporulate in 2.5 % potassium dichromate confirming the presence of bi-cystic bi-zoic oocysts.ResultsA total of 35,157 fecal samples were examined during a ten-year span, of which a third (28.4 %) was stained by the Ziehl-Neelsen carbolfuchsin method diagnosing a total of 125 (1.3 %) C.cayetanensis infections. A statistically significant apparent seasonality was observed most years during May to August (range p < 0.036–0.001), with 83.3 % of 125 cases occurring in those rainy months. All C. cayetanensis cases came from urban poor neighborhoods; male/female relation was 1:1 except in 2006, when all patients were females (p = 0.05; r2 = 22,448). Forty four point eight percent of the stool samples were diarrheic or liquid and 65.6 % infections were identified in children 10 years old or less. Enteric helminths and protozoa co-infected Cyclospora positive patients in 52 instances.: 8 % Ascaris lumbricoides, 8 % Giardia duodenalis, 23.2 % Blastocystis spp. and less frequently Entamoeba histolytica/E. dispar, Strongyloides stercoralis, and Trichuris trichiura.ConclusionsResults suggest a seasonal pattern for Cyclospora infections diagnosed in a clinical setting during the rainy months in Tegucigalpa and surrounding areas. Community studies should be conducted to support or dispute these observations.
Highlights
Document seasonality occurrence and epidemiologic characteristics of Cyclospora cayetanensis infections during a 10-year period from patients consulting at the University Hospital, Honduras
Retrospective observations Oocysts of C. cayetanensis when present in the stools were usually few in number, microscopically identified as round, refringent organisms showing a well delimiting oocyst wall, with regular granulated contents, measuring 8–10 μm in diameter
One hundred and twenty five (1.3 %) Cyclospora infections were identified by acid-fast modified carbolfuchsin staining method (AMS) between 2002 and 2011; at yearly level Cyclospora case incidence presented a cyclical pattern with a slight variation in frequency by month and by year, with a pick in the higher precipitation months of May and June, slowly dropping in July and August, so that 104 of 125 (83.3 %) cases occurred in the 10- year span in those four months
Summary
Document seasonality occurrence and epidemiologic characteristics of Cyclospora cayetanensis infections during a 10-year period from patients consulting at the University Hospital, Honduras. Cyclosporiasis is an enteric illness caused by an infection with Cyclospora cayetanensis oocysts, an intestinal apicomplexan protozoon endemic in many tropical and subtropical regions It was initially reported in 1979 from Papua, New Guinea, and later recovered from immunocompetent travelers and ex-patriates in Nepal [1, 2]. Cyclospora cayetanensis has been identified worldwide as an intestinal pathogen in individuals of all ages It is common in rural and urban areas of tropical and subtropical countries and has been implicated in sporadic outbreaks of gastrointestinal illness in developed countries [4, 5], in travelers to endemic countries [6, 7], in immunocompetent as well as in AIDS patients [8] and in children in endemic areas [9].
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