Volume 75, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


parasites are leading causes of enteric disease, especially in children. A prospective survey on the prevalence of cryptosporidiosis in children less than five years of age was undertaken at six microbiology laboratories in Kenya on fecal samples submitted for routine parasite and ova investigations. Analysis of 4,899 samples over a two-year study period showed an overall prevalence of cryptosporidiosis of 4% that was highest between November to February. Investigations on the nature of enteric diseases prompting ova and cyst examination requests showed 66.4% had acute diarrhea, 9% had persistent diarrhea, and 21% had recurrent diarrhea. The main symptoms were abdominal pain (51.1%), vomiting (51.6%), and abdominal swelling (11%). The prevalence of cryptosporidiosis was highest among children 13–24 months of age (5.2%) and least among those 48–60 months of age (2%). No significant differences were observed by sex but vomiting was slightly higher in males than in females (65% males and 52% females; = 0.07). Cryptosporidiosis was significantly associated with persistent diarrhea ( = 0.0001, odds ratio [OR] = 2.193, 95% confidence interval [CI] = 1.463–3.29), vomiting ( = 0.0273, OR = 1.401, 95% CI = 1.04–1.893), and abdominal swelling ( = 0.0311, OR = 1.56, 95% CI = 1.04–2.34). Genotype analysis based on polymerase chain reaction–restriction fragment length polymorphism of the 18S rRNA gene fragment showed that 87% (153 of 175) of the isolates were , 9% (15 of 175) were , and remaining 4% were , , , and . The most common protozoa in coinfected patients were , , and (6%, 5%, and 2%, respectively). Our results show that is among the most common protozoan parasites in children with enteric diseases and that anthroponotic species are the leading cause of human cryptosporidiosis in Kenya, which suggests that human-to-human transmission is the main mode of spread.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Xiao L, Morgan UM, Fayer R, Thompson RC, Lal AA, 2000. Cryptosporidium systematics and implications for public health. Parasitol Today 16 : 287–292. [Google Scholar]
  2. Xiao L, Ryan UM, 2004. Cryptosporidiosis: an update in molecular epidemiology. Curr Opin Infect Dis 17 : 483–490. [Google Scholar]
  3. Fayer R, Morgan U, Upton SJ, 2000. Epidemiology of Cryptosporidium: transmission, detection and identification. Int J Parasitol 30 : 1305–1322. [Google Scholar]
  4. Tzipori S, Ward H, 2002. Cryptosporidiosis: biology, pathogenesis and disease. Microbes Infect 4 : 1047–1058. [Google Scholar]
  5. Molbak K, Hojlyng N, Gottschau A, Sa JC, Ingholt L, da Silva AP, Aaby P, 1993. Cryptosporidiosis in infancy and childhood mortality in Guinea Bissau, west Africa. BMJ 307 : 417–420. [Google Scholar]
  6. Abdel-Messih IA, Wierzba TF, Abu-Elyazeed R, Ibrahim AF, Ahmed SF, Kamal K, Sanders J, Frenck R, 2005. Diarrhea associated with Cryptosporidium parvum among young children of the Nile River Delta in Egypt. J Trop Pediatr 51 : 154–159. [Google Scholar]
  7. Tumwine JK, Kekitiinwa A, Bakeera-Kitaka S, Ndeezi G, Downing R, Feng X, Akiyoshi DE, Tzipori S, 2005. Cryptosporidiosis and microsporidiosis in Ugandan children with persistent diarrhea with and without concurrent infection with the human immunodeficiency virus. Am J Trop Med Hyg 73 : 921–925. [Google Scholar]
  8. Peng MM, Wilson ML, Holland RE, Meshnick SR, Lal AA, Xiao L, 2003. Genetic diversity of Cryptosporidium spp. in cattle in Michigan: implications for understanding the transmission dynamics. Parasitol Res 90 : 175–180. [Google Scholar]
  9. Gatei W, Ashford RW, Beeching NJ, Kamwati SK, Greensill J, Hart CA, 2002. Cryptosporidium muris infection in an HIV-infected adult, Kenya. Emerg Infect Dis 8 : 204–206. [Google Scholar]
  10. Gatei W, Greensill J, Ashford RW, Cuevas LE, Parry CM, Cunliffe NA, Beeching NJ, Hart CA, 2003. Molecular analysis of the 18S rRNA gene of Cryptosporidium parasites from patients with or without human immunodeficiency virus infections living in Kenya, Malawi, Brazil, the United Kingdom, and Vietnam. J Clin Microbiol 41 : 1458–1462. [Google Scholar]
  11. Laubach HE, Bentley CZ, Ginter EL, Spalter JS, Jensen LA, 2004. A study of risk factors associated with the prevalence of Cryptosporidium in villages around Lake Atitlan, Guatemala. Braz J Infect Dis 8 : 319–323. [Google Scholar]
  12. Newman RD, Sears CL, Moore SR, Nataro JP, Wuhib T, Agnew DA, Guerrant RL, Lima AA, 1999. Longitudinal study of Cryptosporidium infection in children in northeastern Brazil. J Infect Dis 180 : 167–175. [Google Scholar]
  13. Agnew DG, Lima AA, Newman RD, Wuhib T, Moore RD, Guerrant RL, Sears CL, 1998. Cryptosporidiosis in northeastern Brazilian children: association with increased diarrhea morbidity. J Infect Dis 177 : 754–760. [Google Scholar]
  14. Xiao L, Singh A, Limor J, Graczyk TK, Gradus S, Lal A, 2001. Molecular characterization of Cryptosporidium oocysts in samples of raw surface water and wastewater. Appl Environ Microbiol 67 : 1097–1101. [Google Scholar]
  15. Walters IN, Miller NM, van den Ende J, Dees GC, Taylor LA, Taynton LF, Bennett KJ, 1988. Outbreak of cryptosporidiosis among young children attending a day-care centre in Durban. S Afr Med J 74 : 496–499. [Google Scholar]
  16. Fisseha B, Petros B, WoldeMichael T, 1998. Cryptosporidium and other parasites in Ethiopian AIDS patients with chronic diarrhoea. East Afr Med J 75 : 100–101. [Google Scholar]
  17. Adjei A, Lartey M, Adiku TK, Rodrigues O, Renner L, Sifah E, Mensah JD, Akanmori B, Otchere J, Bentum BK, Bosompem KM, 2003. Cryptosporidium oocysts in Ghanaian AIDS patients with diarrhoea. East Afr Med J 80 : 369–372. [Google Scholar]
  18. Estambale BB, Bwibo CR, Kang’ethe S, Chitayi PM, 1989. The occurrence of Cryptosporidium oocysts in faecal samples submitted for routine examination at Kenyatta National Hospital. East Afr Med J 66 : 792–795. [Google Scholar]
  19. Simango C, Mutikani S, 2004. Cryptosporidiosis in Harare, Zimbabwe. Cent Afr J Med 50 : 52–54. [Google Scholar]
  20. Cegielski JP, Ortega YR, McKee S, Madden JF, Gaido L, Schwartz DA, Manji K, Jorgensen AF, Miller SE, Pulipaka UP, Msengi AE, Mwakyusa DH, Sterling CR, Reller LB, 1999. Cryptosporidium, Enterocytozoon, and Cyclospora infections in pediatric and adult patients with diarrhea in Tanzania. Clin Infect Dis 28 : 314–321. [Google Scholar]
  21. Bern C, Ortega Y, Checkley W, Roberts JM, Lescano AG, Cabrera L, Verastegui M, Black RE, Sterling C, Gilman RH, 2002. Epidemiologic differences between cyclosporiasis and cryptosporidiosis in Peruvian children. Emerg Infect Dis 8 : 581–585. [Google Scholar]
  22. Amin OM, 2002. Seasonal prevalence of intestinal parasites in the United States during 2000. Am J Trop Med Hyg 66 : 799–803. [Google Scholar]
  23. Cruz JR, Cano F, Caceres P, Chew F, Pareja G, 1988. Infection and diarrhea caused by Cryptosporidium sp. among Guatemalan infants. J Clin Microbiol 26 : 88–91. [Google Scholar]
  24. Sallon S, el Showwa R, el Masri M, Khalil M, Blundell N, Hart CA, 1991. Cryptosporidiosis in children in Gaza. Ann Trop Paediatr 11 : 277–281. [Google Scholar]
  25. Sallon S, el-Shawwa R, Khalil M, Ginsburg G, el Tayib J, el-Eila J, Green V, Hart CA, 1994. Diarrhoeal disease in children in Gaza. Ann Trop Med Parasitol 88 : 175–182. [Google Scholar]
  26. Baxby D, Hart CA, 1986. The incidence of cryptosporidiosis: a two-year prospective survey in a children’s hospital. J Hyg (Lond) 96 : 107–111. [Google Scholar]
  27. Guerrant DI, Moore SR, Lima AA, Patrick PD, Schorling JB, Guerrant RL, 1999. Association of early childhood diarrhea and cryptosporidiosis with impaired physical fitness and cognitive function four-seven years later in a poor urban community in northeast Brazil. Am J Trop Med Hyg 61 : 707–713. [Google Scholar]
  28. Cegielski JP, Msengi AE, Dukes CS, Mbise R, Redding-Lallinger R, Minjas JN, Wilson ML, Shao J, Durack DT, 1993. Intestinal parasites and HIV infection in Tanzanian children with chronic diarrhea. AIDS 7 : 213–221. [Google Scholar]
  29. Lima AA, Moore SR, Barboza MS Jr, Soares AM, Schleupner MA, Newman RD, Sears CL, Nataro JP, Fedorko DP, Wuhib T, Schorling JB, Guerrant RL, 2000. Persistent diarrhea signals a critical period of increased diarrhea burdens and nutritional shortfalls: a prospective cohort study among children in northeastern Brazil. J Infect Dis 181 : 1643–1651. [Google Scholar]
  30. Khan WA, Rogers KA, Karim MM, Ahmed S, Hibberd PL, Calderwood SB, Ryan ET, Ward HD, 2004. Cryptosporidiosis among Bangladeshi children with diarrhea: a prospective, matched, case-control study of clinical features, epidemiology and systemic antibody responses. Am J Trop Med Hyg 71 : 412–419. [Google Scholar]
  31. Cama VA, Bern C, Sulaiman IM, Gilman RH, Ticona E, Vivar A, Kawai V, Vargas D, Zhou L, Xiao L, 2003. Cryptosporidium species and genotypes in HIV-positive patients in Lima, Peru. J Eukaryot Microbiol 50 (Suppl): 531–533. [Google Scholar]
  32. Xiao L, Bern C, Limor J, Sulaiman I, Roberts J, Checkley W, Cabrera L, Gilman RH, Lal AA, 2001. Identification of 5 types of Cryptosporidium parasites in children in Lima, Peru. J Infect Dis 183 : 492–497. [Google Scholar]
  33. Morgan U, Weber R, Xiao L, Sulaiman I, Thompson RC, Ndiritu W, Lal A, Moore A, Deplazes P, 2000. Molecular characterization of Cryptosporidium isolates obtained from human immunodeficiency virus-infected individuals living in Switzerland, Kenya, and the United States. J Clin Microbiol 38 : 1180–1183. [Google Scholar]
  34. White AC Jr, 2003. Nitazoxanide: an important advance in anti-parasitic therapy. Am J Trop Med Hyg 68 : 382–383. [Google Scholar]

Data & Media loading...

  • Received : 13 Jan 2006
  • Accepted : 23 Mar 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error