PLoS Neglected Tropical Diseases (Jul 2019)

Cryptosporidium infection in rural Gambian children: Epidemiology and risk factors.

  • M Jahangir Hossain,
  • Debasish Saha,
  • Martin Antonio,
  • Dilruba Nasrin,
  • William C Blackwelder,
  • Usman N Ikumapayi,
  • Grant A Mackenzie,
  • Mitchell Adeyemi,
  • Momodou Jasseh,
  • Richard A Adegbola,
  • Anna W Roose,
  • Karen L Kotloff,
  • Myron M Levine

DOI
https://doi.org/10.1371/journal.pntd.0007607
Journal volume & issue
Vol. 13, no. 7
p. e0007607

Abstract

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BackgroundCryptosporidium is a major pathogen associated with diarrheal disease in young children. We studied Cryptosporidium diarrhea in children enrolled in the Global Enteric Multicenter Study (GEMS) in rural Gambia.MethodsWe recruited children ResultsWe enrolled 1938 cases (1381 MSD, 557 LSD) and 2969 matched controls; 231/1929 (12.0%) of diarrhea cases and 141/2962 (4.8%) of controls were positive for Cryptosporidium. Most Cryptosporidium diarrhea cases (85.7%, 198/231) were aged 6-23 months, and most (81.4%, 188/231) occurred during the rainy season. Cryptosporidium hominis (C. hominis) was the predominant (82.6%) species. We found associations between increased risk of Cryptosporidium-positive MSD or LSD, or both, with consumption of stored drinking water and certain animals living in the compound-cow, cat (MSD only) and rodents (LSD only). Larger households, fowl living in the compound, and the presence of Giardia infection were associated with decreased risk of Cryptosporidium MSD and LSD.ConclusionCryptosporidium-positive diarrhea is prevalent in this setting, especially at 6-23 months of age. The preponderance of Cryptosporidium infection in the rainy season and increased risk of Cryptosporidium-positive diarrhea with consumption of stored drinking water suggest water-borne transmission. Further investigation is needed to clarify the role of animals and contamination of stored drinking water in Cryptosporidium transmission.