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Cryptosporidiosis in HIV/AIDS Patients in Kenya: Clinical Features, Epidemiology, Molecular Characterization and Antibody Responses
Jane W. Wanyiri
Jane W. Wanyiri
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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Henry Kanyi
Henry Kanyi
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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Samuel Maina
Samuel Maina
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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David E. Wang
David E. Wang
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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Aaron Steen
Aaron Steen
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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Paul Ngugi
Paul Ngugi
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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Timothy Kamau
Timothy Kamau
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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Tabitha Waithera
Tabitha Waithera
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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Roberta O'Connor
Roberta O'Connor
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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Kimani Gachuhi
Kimani Gachuhi
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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Claire N. Wamae
Claire N. Wamae
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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Mkaya Mwamburi
Mkaya Mwamburi
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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Honorine D. Ward
Honorine D. Ward
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya
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We investigated the epidemiological and clinical features of cryptosporidiosis, the molecular characteristics of infecting species and serum antibody responses to three Cryptosporidium-specific antigens in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in Kenya. Cryptosporidium was the most prevalent enteric pathogen and was identified in 56 of 164 (34%) of HIV/AIDS patients, including 25 of 70 (36%) with diarrhea and 31 of 94 (33%) without diarrhea. Diarrhea in patients exclusively infected with Cryptosporidium was significantly associated with the number of children per household, contact with animals, and water treatment. Cryptosporidium hominis was the most prevalent species and the most prevalent subtype family was Ib. Patients without diarrhea had significantly higher serum IgG levels to Chgp15, Chgp40 and Cp23, and higher fecal IgA levels to Chgp15 and Chgp40 than those with diarrhea suggesting that antibody responses to these antigens may be associated with protection from diarrhea and supporting further investigation of these antigens as vaccine candidates.
Author Notes
Financial support: This study was supported by the NIH Fogarty International Clinical Research Fellows Program (R24 TW007988) to JWW and in part by NIH R01 AI072222 and R01 AI52786 to HDW and the Tufts-Brown Center for AIDS Research 5P30AI042853.
Authors' addresses: Jane W. Wanyiri, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, E-mail: jwanyir1@jhmi.edu. Henry Kanyi, Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya, E-mail: hkanyi@kemri.org. Samuel Maina, International Emerging Infections Program, KEMRI/CDC Research and Public Health Collaboration, Kisumu, Kenya, E-mail: Smaina@ke.cdc.gov. David E. Wang, Roberta O'Connor, and Honorine D. Ward, Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, E-mails: d.wang@alumni.tufts.edu, Roconnor@tuftsmedicalcenter.org, and hward@tuftsmedicalcenter.org. Aaron Steen, Geisel School of Medicine at Dartmouth, White River Junction, VT, E-mail: Aaron.j.steen.dm@dartmouth.edu. Paul Ngugi, Comprehensive Care Center, Kenyatta National Hospital, Nairobi, Kenya, E-mail: ngugi.paul7@gmail.com. Timothy Kamau and Kimani Gachuhi, Center for Biotechnology, Research and Development, Kenya Medical Research Institute, Nairobi, Kenya, E-mails: Tkamau@kemri.org and Kgachuhi@kemri.org. Tabitha Waithera and Claire N. Wamae, Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya, E-mails: tiringu@kemri.org and nwamae@kemri.org. Mkaya Mwamburi, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, E-mail: Mkaya.Mwamburi@tufts.edu.
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