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Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2020, vol. 26, issue1
Subject Area: Medicine
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DOI: 10.5272/jimab.2020261.2985
Published online: 20 March 2020
Original article
J of IMAB. 2020 Jan-Mar;26(1):2985-2990
CRYPTOSPORIDIOSIS IN CHILDREN – CLINICAL FORMS AND CLINICAL CASES
Kalina Stoyanova
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Department of Infectious Diseases, Parasitology and Dermatovenereology, Faculty of Medicine, Medical University - Varna, Bulgaria.
ABSTRACT:
Cryptosporidiosis is one of the most common causes of diarrhoea worldwide, especially in the vulnerable groups of children between 0-5 years and immunocompromised individuals.
The purpose of the study is to estimate the prevalence of the Cryptosporidium infectionin children from North-eastern Bulgaria and to determine the specifics of the clinical forms through the detailed description of several clinical cases.
Material/Methods: Stool samples of 458 children were investigated for the presence of Cryptosporidium spp. oocysts with specialized modified Ziehl–Neelsen staining and with an immunological test for detection of stool antigens. Prevalence estimates are presented in four groups -aged less than five years with or without symptoms and more than five with or without symptoms.
Results: The overall prevalence of cryptosporidiosis in children from North-eastern Bulgaria is 2.18% with the highest incidence (3.06%) in the age group between 0-5 years with diarrhoea. All different types of infestation of the gastrointestinal tract are observed, from an acute infection that requires hospitalization, through mild or persistent diarrhoea and asymptomatic invasion (in1.53%). For each of the specified forms, the details of the clinical presentation, laboratory and physical findings are presented as separate clinical cases.
Conclusions: Our findings demonstrate that broad-spectrum of clinical forms of Cryptosporidium-associated diarrhoea in children exist but up till this study are typically mis- or undiagnosed. The tendency that exists in eastern European countries, including ours, to neglect or underestimate the impact of cryptosporidiosis, is particularly dangerous and should be changed especially in the risk groups of children and immunocompetent adults.
Keywords: Cryptosporidium, cryptosporidiosis, cryptosporidiosis in children, clinical forms, diarrhoea,
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Please cite this article as: Stoyanova K. Cryptosporidiosis in children – clinical forms and clinical cases. J of IMAB. 2020 Jan-Mar;26(1):2985-2990. DOI: 10.5272/jimab.2020261.2985
Correspondence to: Dr. Kalina Stoyanova, Department of Infectious Diseases, Parasitology and Dermatovenerology, Faculty of Medicine, Medical University “Prof. Dr. Paraskev Stoyanov” – Varna; 55, Prof. Marin Drinov Str., Varna 9002, Bulgaria; E-mail: kalina.pavlova@mu-varna.bg
REFERENCES:
1. Shikani H, Weiss LM. Human Cryptosporidiosis: A Clinical Perspective. In: Cryptosporidium: parasite and disease. Caccio SM, Widmer G. (eds). Springer, Vienna. 2014. Part III. pp.383-481. [Crossref ]
2. Checkley W, White AC Jr, Jaganath D, Arrowood MJ, Chalmers RM, Chen XM, et al. A Review of the Global Burden, Novel Diagnostics, Therapeutics, and Vaccine Targets for Cryptosporidium. Lancet Infect Dis. 2015 Jan;15(1):85-94. [PubMed] [Crossref]
3. Caccio SM, Chalmers RM. Human Cryptosporidiosis in Europe. Clin Microbiol Infect. 2016 Jun;22(6):471-80. [PubMed] [Crossref]
4. Khalil IA, Troeger C, Rao PC, Blacker BF, Brown A, Brewer TG, et al. Morbidity, Mortality, and Long-Term Consequences Associated With Diarrhoea From Cryptosporidium Infection in Children Younger Than 5 Years: A Meta-Analyses Study. Lancet Glob Health. 2018 Jul;6(7):e758-e768. [PubMed] [Crossref]
5. Plutzer J, Lassen B, Jokelainen P, Djurković-Djaković O, Kucsera I, Dorbek-Kolin E, et al. Review of Cryptosporidium and Giardia in the Eastern Part of Europe, 2016. Euro Surveill. 2018 Jan 25;23(4):16-00825. [PubMed] [Crossref]
6. GBD Diarrhoeal Diseases Collaborators. Estimates of Global, Regional, and National Morbidity, Mortality, and Aetiologies of Diarrhoeal Diseases: A Systematic Analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017 Sep;17(9):909-948. [PubMed] [Crossref]
7. Horman A, Korpela H, Sutinen J, Wedel H, Hanninen M-L. Meta-analysis in Assessment of the Prevalence and Annual Incidence of Giardia Spp. And Cryptosporidium Spp. Infections in Humans in the Nordic Countries. Int J Parasitol. 2004 Nov;34(12):1337-46. [PubMed] [Crossref]
8. Yancheva N, Tsvetkova N, Marinova I, Elenkov I, Tchervenyakova T, Nikolova M, et al. Prevalence of intestinal parasitic infections in Bulgarian HIV-infected patients. Merit Res J Med Med Sci. 2017 Jan;5(1):001-003. [Internet]
9. UK Standards for Microbiology Investigations. Staining procedures. National Infection Service.PHE Bacteriology – Test Procedures. TP 39. 2019 May; 3. 55 p. [Internet]
10. Stoyanova K, Cvetkova T. [Blastocystosis and invasion with Blastocystis hominis in children and adults in Varna district.] Varna Med Forum. 2016; 5(4):244-249. [in Bulgarian] [Internet]
11. Stoyanova K. [Epidemiological studies and analysis of risk factors in the distribution of intestinal parasitoses with person to person transmission in Varna District] [Dissertation]. Sofia: NCIPD. 2017; 197p. [in Bulgarian] [Crossref]
12. Stoyanova K, Cvetkova T, Rainova I. [Giardiasis in Varna district – prevalence and risk assessment.] Varna Med Forum. 2017; 6(2):487-495. [in Bulgarian] [Internet]
13. Rainova I, Harizanov R, Kaftandjiev I, Tsvetkova N, Mikov O, Kaneva E. Human Parasitic Diseases in Bulgaria in Between 2013-2014. Balk Med J. 2018 Jan 20;35(1):61-67. [PubMed] [Crossref]
14. European Centre for Disease Prevention and Control. Cryptosporidiosis. In: ECDC. Annual epidemiological report for 2016. Stockholm: ECDC; 2018. [Internet]
15. Stoyanova K, Cvetkova T. Point prevalence of intestinal parasites in hospitalized and outpatients with diarrhoea. Probl Infect Parasit Dis. 2017; 45(1):41-46. [Internet]
16. Gospodinova M, Todorov I, Todorova I, Mollova G, Kozmidis M. Rotavirus infections in hospitalized children at the Infectious Diseases Clinic - Varna. Infectology Parasitol Sci. 2015; 2:21-24. [in Bulgarian]
17. Vlkova E, Gospodinova M, Radkova D, Todorov I, Gadzhovska V, Kozmidis M, et al. Clinical manifestations of mixed infections between rotaviruses and other intestinal pathogens. Scr Sci Medica. 2018; 50(4):9-16. [Internet]
18. Stoyanova K, Cvetkova T, Dragomanova S, Pavlov S. Factors limiting the effectiveness of intestinal parasitoses’ pharmacotherapy. J of IMAB. 2017 Oct-Dec;23(4):1713-1717. [Crossref]
Received: 10 June 2019
Published online: 20 March 2020