Cryptosporidial Diarrhoea in Children at a Paediatric Hospital in Accra, Ghana

Abstract

Background: Diarrhoeal diseases are common among children in developing countries, and are caused by several aetiological agents including Cryptosporidium sp.  Several species of this parasite exist which may belong to either anthroponotic or zoonotic forms. With recent application of molecular tools, species involved in human transmission in any locality and sources of infection can now be determined.  Aim: We screened children with acute diarrhoea at a paediatric hospital in Accra, Ghana for enteric parasites to determine frequency of cryptosporidial diarrhoea. Cryptosporidium isolates were then characterized by molecular methods to determine the genetic species in transmission. Methodology: A total of 365 diarrhoeic children of age ≤ 5 years were used in this cross-sectional study. Stool samples were collected and tested for enteric parasites by microscopy and ELISA. Cryptosporidium isolates were subsequently genotyped by PCR-RFLP and confirmed by sequencing of the 18S rRNA gene. Demographic and clinical data were obtained by a structured questionnaire and data analysed for possible association with cryptosporidial diarrhoea. Results: Enteric parasites detected were Cryptosporidium sp. (22.2%), G. lamblia (5.8%) and E. histolytica (0.8%). Neither gender nor breastfeeding habits, presence of domestic animals, source of children’s food, seasons (dry or rainy) appeared to be associated with infection of Cryptosporidium sp. However, age of children, source of drinking water, and education level of mother seems to have association with infection of the parasite. Genotyping results show that C. parvum is the only species involved in transmission. Conclusion:  Cryptosporidium parvum is the commonest enteric parasite causing diarrhoea among children with acute diarrhoea. Children ≤ 3 years and those who drank sachet water were most affected. A carefully planned health education among illiterate mothers and improved sanitary conditions could reduce rate of infections. Further sub-genotyping of C. parvum is needed to determine whether source of infection is zoonotic or anthroponotic.