EJMS

Abstract

Cryptosporidium species are recognized globally as important causes of diarrhea in children and adults. Various methods have been applied to detect oocysts in faeces, but the difficulties of discriminating between non-cryptosporidial bodies, acid fast bodies like cryptosporidia, and cryptosporidia remains. In this study 120 patients with diarrhea were classified as 55 (45.8%) patients with severe diarrhea, 39 (32.5%) patients with moderate diarrhea, and 26 (21.7%) patients with mild diarrhea. Stool samples of all patients were subjected to the following: microscopic examination by concentration techniques, modified Ziehl-Neelsen staining and Enzyme–linked immunosorbent assay (ELISA). Also blood samples were taken from the patients to detect specific antibodies against Cryptosporidium by using Indirect Immunofluorescent technique (IFAT). The study aimed to detect most specific and sensitive methods for diagnosis of Cryptosporidium. The results declared that, the total positive cases with parasitic infection were 95 (79.2%), Cryptosporidium only was detected in (56.8%) of all positive cases. While Cryptosporidium and other parasites were detected in (27.4%) of cases, and (15.8%) of cases were diagnosed as other parasites (Giardia lamblia, E.histolytica, E.coli, B.hominis, A.lumbricoides, Hook worm, and T.trichiura). The results detected the prevalence of cryptosporidiosis among patients having severe, moderate and mild diarrhea as (63.6%, 79.5%, 53.9%) respectively. Non-significant differences were recorded among them (P>0.05). According to age group, cryptosporidiosis was prevalent among age group <10-20 years. Statistical significant differences were recorded among patients according to different age groups (P<0.001), while non-significant differences were recorded according to sex (P>0.05). On correlating cryptosporidiosis with residence, it was more prevalent in rural areas than urban areas (85.7%, 50% respectively). Statistical significant differences were recorded among patients living in rural areas and who were with animal contact (P<0.001). In comparison between microscopic examination, IFAT and ELISA methods for diagnosis of Cryptosporidium, it was revealed that, positive results with 80 (66.7%), 68 (56.7%) and 64 (53.3%) respectively. Non-significant differences were recorded between different methods of examination and types of diarrhea. On detecting the validity of IFAT in comparison to ELISA, IFAT gave a good sensitivity and specificity (96.1% and 89.3 %) respectively. While the validity of microscopic examination in comparison to ELISA showed; good sensitivity and low specificity (87.5% and 56.7 %) respectively. IFAT and microscopic examination showed accuracy with (93.3% and 73.3%) respectively. In conclusion Cryptosporidium is a dangerous cause of gastroenteritis, it has association with young age, rural area and animal contact, while no correlation with sex. IFAT and ELISA are easy and rapid methods for diagnosis of Cryptosporidium, also, they are reliable methods and give reasonable sensitivity and specificity results.