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Molecular Characterization of Cryptosporidium Species and Giardia duodenalis from Symptomatic Cambodian Children.

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Moore, Catrin E, Elwin, Kristin, Phot, Nget, Seng, Chanthou, Mao, Saroeun, Suy, Kuong, Kumar, Varun, Nader, Johanna, Bousfield, Rachel, Perera, Sanuki, Bailey, Wendi, Beeching, Nicholas ORCID: https://orcid.org/0000-0002-7019-8791, Day, Nicholas P J, Parry, Christopher M and Chalmers, Rachel M (2016) 'Molecular Characterization of Cryptosporidium Species and Giardia duodenalis from Symptomatic Cambodian Children.'. PLoS Neglected Tropical Diseases, Vol 10, Issue 7, e0004822.

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Abstract

BACKGROUND
In a prospective study, 498 single faecal samples from children aged under 16 years attending an outpatient clinic in the Angkor Hospital for Children, northwest Cambodia, were examined for Cryptosporidium oocysts and Giardia cysts using microscopy and molecular assays.

METHODOLOGY/PRINCIPAL FINDINGS
Cryptosporidium oocysts were detected in 2.2% (11/498) of samples using microscopy and in 7.7% (38/498) with molecular tests. Giardia duodenalis cysts were detected in 18.9% (94/498) by microscopy and 27.7% (138/498) by molecular tests; 82% of the positive samples (by either method) were from children aged 1-10 years. Cryptosporidium hominis was the most common species of Cryptosporidium, detected in 13 (34.2%) samples, followed by Cryptosporidium meleagridis in 9 (23.7%), Cryptosporidium parvum in 8 (21.1%), Cryptosporidium canis in 5 (13.2%), and Cryptosporidium suis and Cryptosporidium ubiquitum in one sample each. Cryptosporidium hominis and C. parvum positive samples were subtyped by sequencing the GP60 gene: C. hominis IaA16R6 and C. parvum IIeA7G1 were the most abundant subtypes. Giardia duodenalis was typed using a multiplex real-time PCR targeting assemblages A and B. Assemblage B (106; 76.8% of all Giardia positive samples) was most common followed by A (12.3%) and mixed infections (5.1%). Risk factors associated with Cryptosporidium were malnutrition (AOR 9.63, 95% CI 1.67-55.46), chronic medical diagnoses (AOR 4.51, 95% CI 1.79-11.34) and the presence of birds in the household (AOR 2.99, 95% CI 1.16-7.73); specifically C. hominis (p = 0.03) and C. meleagridis (p<0.001) were associated with the presence of birds. The use of soap was protective against Giardia infection (OR 0.74, 95% CI 0.58-0.95).

CONCLUSIONS/SIGNIFICANCE

This is the first report to describe the different Cryptosporidium species and subtypes and Giardia duodenalis assemblages in Cambodian children. The variety of Cryptosporidium species detected indicates both anthroponotic and zoonotic transmission in this population. Interventions to improve sanitation, increase hand washing after defecation and before preparing food and promote drinking boiled water may reduce the burden of these two parasites.

Item Type: Article
Subjects: QX Parasitology > Protozoa > QX 123 Apicomplexa
QX Parasitology > Protozoa > QX 70 Mastigophora. (e.g., Giardia. Trichomonas. Trypanosoma. Leishmania)
WA Public Health > Health Problems of Special Population Groups > WA 320 Child Welfare. Child Health Services.
WI Digestive System > WI 407 Diarrhea
WS Pediatrics > Diseases of Children and Adolescents > By System > WS 312 Diarrheal disorders
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pntd.0004822
Depositing User: Jessica Jones
Date Deposited: 12 Jul 2016 13:43
Last Modified: 09 Sep 2019 06:27
URI: https://archive.lstmed.ac.uk/id/eprint/5974

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