High Anti-Cryptosporidium parvum IgG Seroprevalence in HIV-Infected Adults in Limpopo, South Africa

Luther A. Bartelt Center for Global Health, Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia; Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila, Philippines; HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo, South Africa; Department of Microbiology, University of Venda, Thohoyandou, Limpopo, South Africa

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Jesus Emmanuel Sevilleja Center for Global Health, Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia; Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila, Philippines; HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo, South Africa; Department of Microbiology, University of Venda, Thohoyandou, Limpopo, South Africa

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Leah J. Barrett Center for Global Health, Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia; Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila, Philippines; HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo, South Africa; Department of Microbiology, University of Venda, Thohoyandou, Limpopo, South Africa

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Cirle A. Warren Center for Global Health, Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia; Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila, Philippines; HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo, South Africa; Department of Microbiology, University of Venda, Thohoyandou, Limpopo, South Africa

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Richard L. Guerrant Center for Global Health, Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia; Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila, Philippines; HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo, South Africa; Department of Microbiology, University of Venda, Thohoyandou, Limpopo, South Africa

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Pascal O. Bessong Center for Global Health, Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia; Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila, Philippines; HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo, South Africa; Department of Microbiology, University of Venda, Thohoyandou, Limpopo, South Africa

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Rebecca Dillingham Center for Global Health, Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia; Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila, Philippines; HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo, South Africa; Department of Microbiology, University of Venda, Thohoyandou, Limpopo, South Africa

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Amidou Samie Center for Global Health, Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia; Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines, Manila, Philippines; HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo, South Africa; Department of Microbiology, University of Venda, Thohoyandou, Limpopo, South Africa

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A seroepidemiological study was performed to determine the seroprevalence of Cryptosporidium in human immunodeficiency virus (HIV)-infected adults and local university students in the Limpopo Province, South Africa. Using a custom anti-C. parvum immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA), the seroprevalence of Cryptosporidium was found to be significantly higher (75.3%; 146 of 193) in HIV-infected individuals compared with student volunteers (32.8%; 19 of 58) (P < 0.001). A more recent diagnosis of HIV was associated with anti-C. parvum IgG seropositivity, as was lower weight among HIV-infected women. This is the first seroepidemiologic study of Cryptosporidium in rural South Africa, and it shows high endemicity among the HIV-infected population. In addition to raising the possibility of significant Cryptosporidium-related morbidities, this finding reveals that in Limpopo and perhaps in other low-income, rural populations, interrupting waterborne pathogen transmission will require strategies effective against environmentally hardy parasites such as Cryptosporidium.

Author Notes

* Address correspondence to Luther A. Bartelt, University of Virginia, P.O. Box 801379, Charlottesville, VA 22908. E-mail: lab2za@virginia.edu

Financial support: This study was supported by the Pfizer Initiative in International Health, Pfizer Foundation and the University of Virginia Department of Internal Medicine and Center for Global Health. LAB is supported in part by NIH Research in Digestive Diseases Training (2T32DK007769-11) grant. RAD is supported by a NIAID Career Development Award: K23AI077339.

Authors' addresses: Luther A. Bartelt, Leah J. Barrett, Cirle A. Warren, Richard L. Guerrant, and Rebecca Dillingham, University of Virginia, Charlottesville, VA, E-mails: lab2za@virginia.edu, ljb6v@virginia.edu, ca6t@virginia.edu, rlg9A@virginia.edu, and rd8v@virginia.edu. Jesus Emmanuel Sevilleja, National Institutes of Health, University of the Philippines, Manila, Philippines, E-mail: emsevilleja@yahoo.com. Pascal O. Bessong and Amidou Samie, University of Venda, Thohoyandou, Limpopo, South Africa, E-mails: Pascal.Bessong@univen.ac.za and samieamidou@yahoo.com.

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