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Cryptosporidium Infections in Mexican Children: Clinical, Nutritional, Enteropathogenic, and Diagnostic Evaluations
F. Javier Enriquez
F. Javier Enriquez
Department of Veterinary Science, University of Arizona, Department of Infectious Diseases, Hospital Infantil de Mexico Federico Gomez, Tucson, Arizona, Mexico
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Carlos R. Avila
Carlos R. Avila
Department of Veterinary Science, University of Arizona, Department of Infectious Diseases, Hospital Infantil de Mexico Federico Gomez, Tucson, Arizona, Mexico
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Jose Ignacio Santos
Jose Ignacio Santos
Department of Veterinary Science, University of Arizona, Department of Infectious Diseases, Hospital Infantil de Mexico Federico Gomez, Tucson, Arizona, Mexico
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Jorge Tanaka-Kido
Jorge Tanaka-Kido
Department of Veterinary Science, University of Arizona, Department of Infectious Diseases, Hospital Infantil de Mexico Federico Gomez, Tucson, Arizona, Mexico
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Octavio Vallejo
Octavio Vallejo
Department of Veterinary Science, University of Arizona, Department of Infectious Diseases, Hospital Infantil de Mexico Federico Gomez, Tucson, Arizona, Mexico
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Charles R. Sterling
Charles R. Sterling
Department of Veterinary Science, University of Arizona, Department of Infectious Diseases, Hospital Infantil de Mexico Federico Gomez, Tucson, Arizona, Mexico
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Using an indirect immunofluorescence assay on stool samples, we found a 6.4% prevalence of cryptosporidiosis among 403 children less than five years of age with acute diarrhea in Mexico City over a one-year period. The prevalence was highest (11.4%) during the rainy summer months. Most Cryptosporidium parvum cases occurred in infants less than one year of age. Cryptosporidium parvum was more common in malnourished children (P < 0.05) and in nonbreast-fed infants less than six months of age (P < 0.01). Neither dwelling characteristics nor the presence of domestic animals at home were associated with C. parvum infection. Enteropathogenic bacteria were found in 26.8% of the children; Escherichia coli, Salmonella, and Shigella being the most frequently identified. None of 100 serum samples tested showed antibodies against human immunodeficiency virus. When compared with immunofluorescence, the acid-fast technique showed a sensitivity of 76.9% and a specificity of 98.9%, with a predictive positive value of 83.3%. It was concluded that 1) monoclonal antibody-based immunofluorescence is a better diagnostic tool than the acid-fast technique, 2) the prevalence of cryptosporidiosis in this population was similar to that of other developing countries, 3) clinical manifestations were nonspecific, and 4) C. parvum was more common in malnourished children and in nonbreast-fed infants.
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