Korean J Parasitol.  2014 Oct;52(5):479-485. 10.3347/kjp.2014.52.5.479.

Prevalence of Cryptosporidium-Associated Diarrhea in a High Altitude-Community of Saudi Arabia Detected by Conventional and Molecular Methods

• Hawash Y
• Dorgham LS
• Al-Hazmi A
• Al-Ghamdi

• KMID: 1792212
• DOI: http://doi.org/10.3347/kjp.2014.52.5.479

Abstract

Cryptosporidium diarrhea represents a relevant clinical problem in developing countries. In Al-Taif, a city of Saudi Arabia that lies at an altitude of an around 2 km above the sea level, Cryptosporidium infection seems to be undiagnosed in nearly all clinical laboratories. Furthermore, nothing was published regarding Cryptosporidium-associated diarrhea in this area. The objectives of this research were to (1) determine the Cryptosporidium prevalence among patients with diarrhea and (2) to estimate the performances of 3 different diagnostic methods. Total 180 diarrheal fecal samples, 1 sample per patient, were collected between January and August 2013. Samples were screened for Cryptosporidium with modified Zeihl Neelsen (ZN) microscopy, RIDA(R) Quick lateral flow (LF) immunotest, and a previously published PCR. The Cryptosporidium prevalence rate was 9.4% (17/180), 10% (18/180), and 11.6% (21/180) by microscopy, LF, and PCR test, respectively. Infection was significantly (P=0.004) predominant among children <5 years (22%) followed by children 5-9 years (11.1%). Although infection was higher in males than in females (16.2% males and 8.5% females), the difference was not statistically significant (P=0.11). Compared to PCR, the sensitivity of microscopy and the LF test were 80.9%, 85.7%, respectively. To conclude, high Cryptosporidium-associated diarrhea was found in this area especially in children < or =9 years. The PCR test showed the best performance followed by the LF test and ZN staining microscopy. The primary health care providers in Al-Taif need to be aware of and do testing for this protozoon, particularly for children seen with diarrhea.

Keyword

Cryptosporidium; diarrhea; high altitude; microscopy; lateral flow test; PCR

MeSH Terms

Adolescent
Adult
*Altitude
Child
Child, Preschool
Cryptosporidiosis/*epidemiology
Cryptosporidium/*isolation & purification
Diarrhea/epidemiology/*parasitology
Female
Humans
Male
Middle Aged
Prevalence
Saudi Arabia/epidemiology
Young Adult