Unique endemicity of cryptosporidiosis in children in Kuwait

Abstract

To understand the transmission of Cryptosporidium infection in children, fecal specimens from 62 Kuwaiti children with gastrointestinal symptoms found to be positive by microscopy were genotyped and subtyped with a small subunit rRNA-based PCR-restriction fragment length polymorphism analysis and a 60-kDa glycoprotein-based DNA sequencing tool. The median age of infected children was 4.5 years, and 77% of infections occurred during the cool season of November to April. Fifty-eight of the children (94%) had Cryptosporidium parvum, three (5%) had Cryptosporidium hominis, and one (1%) had both C. parvum and C. hominis. Altogether, 13 subtypes of C. parvum (belonging to four subtype allele families) and C. hominis (belonging to three subtype allele families) were observed, with 92% of specimens belonging to the common allele family IIa and the unusual allele family IId. Thus, the transmission of cryptosporidiosis in Kuwaiti children differed significantly from other tropical countries.

FIG. 1.

The seasonal distribution of cryptosporidiosis cases in Kuwaiti children.

FIG. 2.

The presence of multiple C. parvum subtypes in Kuwaiti children as revealed by a neighbor-joining analysis of the sequences of GP60. IIa, IIc, IId, and IIf are C. parvum allele families; Ib, Id, and Ie are C. hominis allele families. The numbers on branches are bootstrap values greater than 50%.