Cryptosporidiosis in infancy and childhood mortality in Guinea Bissau, west Africa.
OBJECTIVE
To investigate the epidemiology of and mortality from cryptosporidiosis in young children in Guinea Bissau, West Africa.


METHODS
Three year community study of an open cohort followed up weekly.


METHODS
301 randomly selected houses in a semi-urban area in the capital, Bissau.


METHODS
1315 children aged less than 4 years.


METHODS
Cryptosporidium infection detected by examination of stools during episode of diarrhoea and death of a child.


RESULTS
Cryptosporidium spp were found in 239 (7.4%) out of 3215 episodes of diarrhoea. The parasite was most common in younger children (median age 12 months) and at the beginning of the rainy seasons. The prevalence of cryptosporidiosis was 15% (77/513) in cases of persistent diarrhoea compared with 6.1% (148/2428) in diarrhoea lasting less than two weeks (p < 0.0001). Cryptosporidiosis was associated with excess mortality in children who had the infection in infancy, and this excess mortality persisted into the second year of life (relative mortality 2.9 (95% confidence interval 1.7 to 4.9)). The excess mortality could not be explained by malnutrition, or by socioeconomic factors, hygienic conditions, or breast feeding.


CONCLUSIONS
Cryptosporidiosis is an important cause of death in otherwise healthy children in developing countries.
Laboratory of Parasitology, Statens Seruminstitut, Copenhagen, Denmark.
K
K
Mølbak
N
N
Højlyng
A
A
Gottschau
J C
JC
Sá
L
L
Ingholt
A P
AP
da Silva
P
P
Aaby
D002675:Child, Preschool; D015331:Cohort Studies; D003457:Cryptosporidiosis / Q000453:epidemiology* / Q000401:mortality; D003967:Diarrhea / Q000469:parasitology; D005260:Female; D006169:Guinea-Bissau / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D009752:Nutritional Status; D015995:Prevalence; D011897:Random Allocation; D012621:Seasons; D016019:Survival Analysis