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Identification of Cryptosporidium Species Infecting Humans in Tunisia

Prevalence and species distribution of Cryptosporidium spp. were determined among 633 immunocompetent children less than five years of age and 75 patients hospitalized for immunodeficiency who lived in northern Tunisia. Microscopy was used for initial screening to detect positive samples and a nested polymerase chain reaction and restriction fragment length polymorphism analysis was used to determine the species. Cryptosporidium spp. was identified in 2.7% of cases (19 stool samples), and there was a significant difference between samples collected from immunocompromised patients and those collected from healthy children (10.7% versus 1.7%). Prevalence was also significantly higher in diarrheal specimens than in formed specimens (6.3% versus 1.6%). Cryptosporidium hominis and C. parvum were responsible for most Cryptosporidium spp. infections (78.9%). Cryptosporidium hominis was more prevalent in children from urban areas than in those from rural areas, and C. parvum was found with similar prevalence rates in the two populations. Cryptosporidium meleagridis was identified in four children on farms.

Received January 28, 2008. Accepted for publication June 20, 2008.

Acknowledgments: We thank Dr. Ezzedine Brahem, Dr. Ridha Hamza, doctors and health agents from the Regional Directory of Public Health of Bizerte, doctors and nurses from PMI Cité Hllal, Tunis, and PMI Ibn Khaldoun, Tunis, for facilitated data and stool collection from healthy children. We also thank Professor Taoufik Ben Chaabane (Department of Infectious Diseases, La Rabta Hospital, Tunis, Tunisia), Ikram Rahmouni, and Nejla Chabchoub (Department of Parasitology, Pasteur Institute of Tunis, Tuynis, Tunisia) for cooperation and help.

Financial support: This study was supported by the Institut de Medecine et d’Epidémiologie Appliqué e–Fondation Internationale Leon Mba, France, and the Ministry of Higher Education, Research and Technology, Tunisia in the setting of the Research Laboratory Parasitoses Emergentes (LR 05SP03).

^* Address correspondence to Aïda Bouratbine, Laboratoire de Parasitologie, Institut Pasteur de Tunis, 13 Place Pasteur, BP 74, 1002 Tunis Belvedère, Tunisia. E-mail: aida.bouratbine{at}pasteur.rns.tn

Authors’ addresses: Rym Essid, Karim Aoun, and Aïda Bouratbine, LR Parasitoses Emergentes, Laboratoire de Parasitologie, Institut Pasteur de Tunis, 13 Place Pasteur, BP 74, 1002 Tunis Belvedère, Tunisia. Mohamed Mousli, Laboratoire d’ Immunologie-Vaccinologie-Genetique Moléculaire, Institut Pasteur de Tunis, 13 Place Pasteur, BP 74, 1002 Tunis Belvedère, Tunisia. Rim Abdelmalek and Fakher Kanoun, Service des Maladies Infectieuses, la Rabta, 1007 Jebbari Tunis, Tunisia. Fethi Mellouli, Service d’Immuno-Hématologie Pédiatrique, Centre de Greffe de Moelle Oseuse, 2 Rue Djebel Lakhdhar, Tunis, Tunisia. Francis Derouin, Laboratoire de Parasitologie-Mycologie, Hopital Saint Louis, Assistance Publique Hôpitaux de Paris et Faculté Denis Diderot, 1 Avenue Claude Vellefaux 75 010, Paris, France.

Reprint requests: Aïda Bouratbine, Laboratoire de Parasitologie, Institut Pasteur de Tunis, 13 Place Pasteur, BP 74, 1002 Tunis Belvedère, Tunisia, Tel: 216-71-890-827, Fax: 216-71791-833, E-mail: aida.bouratbine{at}pasteur.rns.tn.