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. 2015 Oct 9;9(10):e0004125.
doi: 10.1371/journal.pntd.0004125. eCollection 2015.

Prevalence of Cryptosporidium parvum/hominis, Entamoeba histolytica and Giardia lamblia among Young Children with and without Diarrhea in Dar es Salaam, Tanzania

Marit G Tellevik  1 , Sabrina J Moyo  2 , Bjørn Blomberg  3 , Torunn Hjøllo  4 , Samuel Y Maselle  5 , Nina Langeland  6 , Kurt Hanevik  7
Affiliations

Prevalence of Cryptosporidium parvum/hominis, Entamoeba histolytica and Giardia lamblia among Young Children with and without Diarrhea in Dar es Salaam, Tanzania

Marit G Tellevik et al. PLoS Negl Trop Dis. .

Abstract

Background: Although enteroparasites are common causes of diarrheal illness, few studies have been performed among children in Tanzania. This study aimed to investigate the prevalence of Cryptosporidium parvum/hominis, Entamoeba histolytica and Giardia lamblia among young children in Dar es Salaam, Tanzania, and identify risk factors for infection.

Methodology/principal findings: We performed an unmatched case-control study among children < 2 years of age in Dar es Salaam, recruited from August 2010 to July 2011. Detection and identification of protozoans were done by PCR techniques on DNA from stool specimens from 701 cases of children admitted due to diarrhea at the three study hospitals, and 558 controls of children with no history of diarrhea during the last month prior to enrollment. The prevalence of C. parvum/hominis was 10.4% (84.7% C. hominis), and that of G. lamblia 4.6%. E. histolytica was not detected. The prevalence of Cryptosporidium was significantly higher in cases (16.3%) than in controls (3.1%; P < 0.001; OR = 6.2; 95% CI: 3.7-10.4). G. lamblia was significantly more prevalent in controls (6.1%) than in cases (3.4%; P = 0.027; OR = 1.8; 95% CI: 1.1-3.1). Cryptosporidium infection was found more often in HIV-positive (24.2%) than in HIV-negative children (3.9%; P < 0.001; OR = 7.9; 95% CI: 3.1-20.5), and was also associated with rainfall (P < 0.001; OR = 2.41; 95% CI: 1.5-3.8). Among cases, stunted children had significantly higher risk of being infected with Cryptosporidium (P = 0.011; OR = 2.12; 95% CI: 1.2-3.8). G. lamblia infection was more prevalent in the cool season (P = 0.004; OR = 2.2; 95% CI: 1.3-3.8), and more frequent among cases aged > 12 months (P = 0.003; OR = 3.5; 95% CI: 1.5-7.8). Among children aged 7-12 months, those who were breastfed had lower prevalence of G. lamblia infection than those who had been weaned (P = 0.012).

Conclusions: Cryptosporidium infection is common among young Tanzanian children with diarrhea, particularly those living with HIV, and infection is more frequent during the rainy season. G. lamblia is frequently implicated in asymptomatic infections, but rarely causes overt diarrheal illness, and its prevalence increases with age.

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Conflict of interest statement

Kurt Hanevik has previously been a member of an advisory board for Lupin Pharmaceuticals, Baltimore, USA. Otherwise, there are no conflicts of interest. This does not alter our adherence to all PLOS NTDs policies on sharing data and materials.

Figures

Fig 1
Fig 1. Prevalence of Cryptosporidium infection, G. lamblia infection and total rainfall each month during the study period.
The graph shows the prevalence (%) of Cryptosporidium infection and G. lamblia infection among all study participants, together with the total rainfall in mm, for each month during the study period.
Fig 2
Fig 2. Prevalence of Cryptosporidium and G. lamblia for the different age groups.
The graph shows the prevalence of (A) Cryptosporidium infection and (B) G. lamblia infection for the different age groups.
See this image and copyright information in PMC

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