Burden of intestinal parasites in a cohort of diarrheic Egyptian children: Predominance of Cryptosporidium using nested PCR assay

Document Type : Original Article

Authors

1 Departments of Medical Parasitology, Faculties of Medicine, Universities of Helwan

2 Departments of Medical Parasitology, Faculties of Medicine, Universities Al-Azhar

3 Departments of Medical Parasitology, Faculties of Medicine, Universities of Cairo (Laboratory of Molecular Medical Parasitology, LMMP), Genetic Engineering and Biotechnology Research Institute, University of Sadat city

4 Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

Abstract

Background: Diarrheic children are more vulnerable to a variety of pathogens including gastrointestinal
parasites. Cryptosporidiosis is a major etiology of chronic diarrhea in Egyptian children; it has both shortand
long-term consequences for their growth and development.
Objective: The purpose of this study was to determine in a cohort of children with diarrhea the prevalence
of Cryptosporidium spp., molecularly; and other intestinal parasites, coproscopically, and to assess the
association between Cryptosporidium and patient characteristics. As well as to evaluate the usefulness of
molecular assay in detection of cryptosporidiosis in diarrheic children.
Subjects and Methods: Fecal specimens were collected from 102 diarrheic Egyptian children, aged 12
years and under. All fecal specimens were examined coproscopically by wet mount prior to and after
concentration, as well as permanent staining with modified acid-fast (MAF) for detection of intestinal
parasites. Molecular assay using nested PCR (nPCR) was performed for detection of Cryptosporidium
oocyst wall protein (cowp) gene. The association of patient demographics and clinical data with detection
of Cryptosporidium spp. was determined.
Results: Cryptosporidium copro-DNA was detected in 12 (11.8%) cases, for 5 (4.9%) of which oocysts
were detected by MAF coproscopy; 9 cases of E. histolytica complex and 7 cases of G. intestinalis were
detected by coproscopy. Other than the measure of head circumference, none of the patient characteristics
had a significant association (P=0.027) with the detection of Cryptosporidium.
Conclusion: There is a clear predominance of intestinal protozoa in diarrheic children, and Cryptosporidium
spp. was the major enteric pathogen. Molecular assay should be included for the routine laboratory
diagnosis of cryptosporidiosis.

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