The Risk of Reported Cryptosporidiosis in Children Aged

Aparna Lal,Martyn Kirk,Emily Fearnley

doi:10.3390/ijerph120911815

Abstract

The incidence of cryptosporidiosis is highest in children <5 years, yet little is known about disease patterns across urban and rural areas of Australia. In this study, we examine whether the risk of reported cryptosporidiosis in children <5 years varies across an urban-rural gradient, after controlling for season and gender. Using Australian data on reported cryptosporidiosis from 2001 to 2012, we spatially linked disease data to an index of geographic remoteness to examine the geographic variation in cryptosporidiosis risk using negative binomial regression. The Incidence Risk Ratio (IRR) of reported cryptosporidiosis was higher in inner regional (IRR 1.4 95% CI 1.2–1.7, p < 0.001), and outer regional areas (IRR 2.4 95% CI 2.2–2.9, p < 0.001), and in remote (IRR 5.2 95% CI 4.3–6.2, p < 0.001) and very remote (IRR 8.2 95% CI 6.9–9.8, p < 0.001) areas, compared to major cities. A linear test for trend showed a statistically significant trend with increasing remoteness. Remote communities need to be a priority for future targeted health promotion and disease prevention interventions to reduce cryptosporidiosis in children <5 years.

Highlights

Cryptosporidiosis, caused by the parasite Cryptosporidium, manifests as gastroenteritis and is transmitted by the faecal—oral route [1]
From 2001–2012, there were a total of 12,949 cases of cryptosporidiosis reported in children
We found a summer to early autumn peak in cryptosporidiosis incidence, similar to that previously reported in the United States [48], and a general increase in infectious gastroenteritis in Australia over summer [49]

Summary

Introduction

Cryptosporidiosis, caused by the parasite Cryptosporidium, manifests as gastroenteritis and is transmitted by the faecal—oral route [1]. Cryptosporidium infection may be spread by contact with infected animals or humans, or consumption of contaminated water and foods [2,3,4,5,6,7]. Cryptosporidium spp. oocysts are resistant to high concentrations of chemical disinfectants commonly used to treat water for drinking or recreational use, and the infectious dose required to induce infection is relatively small [8]. The oocysts can persist in the environment for a prolonged time [1]. The low infectious dose and extended infectious capability of Cryptosporidium spp. help explain why it is transmitted through the environment and how the disease is a challenge to control. The recent Global Enteric Multi-Centre Study estimated that cryptosporidiosis was associated with a significant increase in the risk of death in children aged 12–23 months in low income countries [9]

Methods

Results

Discussion

Conclusion