Prevalence of Cryptosporidium species among HIV positive asymptomatic and symptomatic immigrant population in Kashmir, India
-
S Masarat
,
F Ahmad
,
M Chisti
,
S Hamid
,
B Ahmad Sofi
Abstract
Background and Objectives: Cryptosporidiosis has not been reported as an endemic disease in Kashmir, but high prevalence of Cryptosporidium sp. has been found among asymptomatic (non-diarrheic) HIV positive immigrants in present study. Due to increasing number of HIV positive immigrants in Kashmir, Cryptosporidium may become a public health problem in Kashmir.
Materials and Methods: A total of 45 stool samples were obtained from symptomatic (diarrheic n = 9) and asymptomatic (non-diarrheic n = 36) patients infected with HIV. The stool samples were concentrated using formalin ethyl acetate concentration technique, stained with modified Kinyoun’s cold stain and oocysts were identified by microscopy under 1000 x magnification. It was confirmed by detection of antigens in stool samples by ELISA.
Results: It was established that all the patients studied were carriers of Cryptosporidium. In present study though 80% of patients were asymptomatic (non-diarrheic) and HIV positive which involved non-Kashmiri army personals and travelers (immigrants) but were carriers of Cryptosporidium and 20% of HIV positive patients were emigrants (local Kashmiri traders) who travelled different states of India were having diarrhea (symptomatic) as well as carrier of Cryptosporidium.
Conclusion: Though Cryptosporidium infection causes chronic diarrhea but in present study all HIV positive patients screened whether diarrheic or non-diarrheic were positive for Cryptosporidium. To prevent the transmission of Cryptosporidium oocyst in environment and endemic spread of cryptosporidiosis as non-diarrheic HIV positive population may be potential source of infection, obligatory laboratory testing for Cryptosporidium in HIV positive immigrant population like traders and travelers is highly recommended in order to have a better understanding of the cause of spread Cryptosporidium infection in Kashmir.
Flanigan T, Whalen C, Turner J, Soave R, Toerner J, Havlir D, et al. Cryptosporidium infection and CD4 counts. Ann Intern Med 1992; 116: 840-842.
Smith NH, Cron S, Valdez LM, Chappell CL, White AC . Combination drug therapy for cryptosporidiosis in AIDS. J Infect Dis 1998; 159: 1160-1162.
Mac Kenzie WR, Hoxie NJ, Proctor ME, Gradus MS, Blair KA, Peterson DE. A massive outbreak in Milwaukee of Cryptosporidium infection transmitted through the public water supply. N Engl J Med 1994;331: 161-167.
Rodrigues JLN, Leser P, Silva TMJ, Santos MID, Dalboni MA, Acceturi CA, et al. Prevalencia da criptosporidio senasindrome diarreica do paciente HIV positivo. Rev Assoc Med Brasil 1991; 37: 79-84.
Colebunders R, Lusakumuni K, Nelson AM, Gigase P, Lebughe I, Van Marck E, et al. Persistent diarrhea in Zairian AIDS patients: an endoscopic and histological study. Gut 1988; 29: 1687-1691.
Chen YG, Yao FB, Li HS, Shi WS, Dai MX, Lu M.Cryptosporidium infection and diarrhea in rural and urban areas of Jiangsu, People’s Republic of China. J Clin Microbiol 1992; 30: 492-494.
Shahid NS, Rahman ASMH, Anderson BC, Mata LJ, Sanyal SC. Cryptosporidiosis in Bangladesh. Br Med J 1985; 290: 114-115.
Joshi M, Chowdhary AS, Dalal PJ, Maniar JK. Parasitic diarrhoea in patients with AIDS. Natl Med J India 2002;15: 72-74.
Agarwal A, Ningthouja S, Sharma D, Mohen Y, Singh NB. Cryptosporidium and HIV. J Indian Med Assoc 1998; 96: 276-277.
Das P, Sengupta K, Dutta P, Bhattacharya MK, Pal SC, Bhattacharya SK, et al. Significance of Cryptosporidium as an aetiologic agent of acute diarrhoea in Calcutta: a hospital based study. J Trop Med Hyg 1993; 96: 124-127.
Petersen C. Cryptosporidiosis in patients infected with the human immunodeficiency virus. Clin Infect Dis.1992; 15: 903-909.
Ng KP, Shekhar KC. The prevalence of cryptosporidiosis in children and adults at University Hospital, Kuala Lumpur. Med J Malaysia 1993; 48: 293-296.
Pedersen C, Danner S, Lazzarin A, Glauser MP, Weber R, Katlama C, et al. Epidemiology of cryptosporidiosis among European AIDS patients. Genitourin Med. 1996; 72: 128-131.
Chacin-Bonilla L, Guanipa N, Cano G, Raleigh X, Quijada L. Cryptosporidiosis among patients with acquired immunodeficiency syndrome in Zulia state, Venezuela. Am J Trop Med Hyg 1992; 47: 582-586.
Fretz R,Svoboda P,Ryan UM,Thompson RC,Tanners M, Baumgartner A. Genotyping of Cryptosporidium spp. isolated from human stool specimens in Switzerland. Epidemiol Infect. 2003; 131: 663-667.
Molloy SF, Smith HV, Kirwan P, Nichols RAB, Asaolu SO, Connelly L et al. Identification of a high diversity of Cryptosporidium species genotypes and subtypes in a pediatric population in Nigeria. Am J Trop Med Hyg 2010; 82: 608-613.
Xiao L, Bern C, Limor J, Sulaiman I, Roberts J, Checkley W, et al. Identification of 5 types of Cryptosporidium parasites in children in Lima, Peru J Infect Dis 2001;183: 492-497.
Xiao L., Ryan UM. (2008). Molecular epidemiology In Cryptosporidium and Cryptosporidiosis, Second Edition, Fayer R. & Xiao L. eds. CRC Press and IWA Publishing, 1075 Boca Raton, FL, USA, 387-410.
Lorenza putignami and Donato Menichella Global Distribut-ion, Public Health and Clinical Impact of the Protozoan Pathogen Cryptosporidium. Interdisciplinary Perspectives on Infectious Diseases 2010; 10:1155 (39 pages).
Hunter PR, Nichols G. Epidemiology and clinical features of Cryptosporidium infection in immunocompromised patients. Clin Microbiol Rev 2002; 15: 145-54.
Ajjampur SS, Sankaran P, Kang G. Cryptosporidium species in HIV-infected individuals in India: an overview. Natl Med J India 2008; 21: 178-184.
Gassama A, Sow PS, Fall F, Camara P, Gueye- N’diaye A, Seng R, et al. Ordinary and opportunistic enteropathogens associated with diarrhea in Senegalese adults in relation to human immunodeficiency virus sero-status. Int J Infect Dis 2001; 5: 192-198.
Gumbo T, Sarbah S, Gangaidzo IT, Ortega Y, Sterling CR, Carville A, et al. Intestinal parasites in patients with diarrhea and human immunodeficiency virus infection in Zimbabwe. AIDS 1999; 13: 819-821.
Tarimo DS, Killewo JZ, Minjas JN, Msamanga GI.Prevalence of intestinal parasites in adult patients with enteropathic AIDS in north-eastern Tanzania. East Afr Med J 1996; 73: 397-399.
Blanshard C, Jackson AM, Shanson DC, Francis N, Gazzard BG. Cryptosporidiosis in HIV-seropositive patients. QJM 1992; 85: 813-823.
Manabe YC, Clark DP, Moore RD, Lumadue JA, Dahlman HR, Belitsos PC, et al. Cryptosporidiosis in patients with AIDS: correlates of disease and survival. Clin Infect Dis 1998; 27: 536-542.
Cranendonk RJ, Kodde CJ, Chipeta D, Zijlstra EE, Sluiters JF. Cryptosporidium parvum and Isospora belli infections among patients with and without diarrhea. East Afr Med J 2003; 80: 398-401.
Current WL, Garcia LS. Cryptosporidiosis Clin.Microbiol Rev. 1991; 4: 325-358.
Checkley W, Gilman RH, Suarez M, Diaz JF, Cabrera L, Black RE, et al. Asymptomatic and Symptomatic cryptosporidiosis: their acute effect on weight gain in Peruvian children. Am J Epid 1997; 145: 156-163.
Houpt E, Bushen OY, Sam NE, Kohli A, Asgharpour A, Ng CT, et al. Short report: asymptomatic Cryptosporidium hominis infection among human immunodeficiency virus-infected patients in Tanzania. Am J Trop Med Hyg 2005; 73: 520-522.
Kamel AG, Maning N, Arulmainathan S, Murad S, Nasuruddin A, Lai KP. Cryptosporidiosis among HIV positive intravenous drug users in Malaysia. Southeast Asian J Trop Med Public Health.1994; 25: 650-653.
Ravn P, Lundgren JD, Kjaeldgaard P, Holten-Anderson W, Højlyng N, Nielsen JO. Nosocomial outbreak of cryptosporidiosis in AIDS patients. Br Med J 1991; 302:277-280.
| Files | ||
| Issue | Vol 4 No 1 (2012) | |
| Section | Articles | |
| Keywords | ||
| Asymptomatic and Symptomatic Cryptosporidium HIV-Infection emigrants immigrants | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
