Epidemiology and treatment of Cyclospora cayetanensis infection in Peruvian children.
Cyclospora cayetanensis was detected in fecal specimens from 63 (1.1%) of 5,836 Peruvian children studied over 2 years; the protozoan was detected by modified acid-fast staining and autofluorescence under ultraviolet light. The highest prevalence occurred among children between 2 and 4 years of age. Thirty-two percent (20) of the 63 C. cayetanensis-infected children were symptomatic. Nineteen infected children were enrolled in a double-blind, placebo-controlled trial of a 3-day course of trimethoprim-sulfamethoxazole (TMP-SMZ; 5/25 mg/[kg x d]). Children were followed up with daily stool examinations (mean number of samples examined per child +/- SE, 19 +/- 4). The mean duration of oocyst excretion +/- SE was 4.8 +/- 1.2 days for TMP-SMZ recipients compared with 12.1 +/- 6.1 days for placebo recipients (P < .02). The prevalence of C. cayetanensis infection decreases during winter months and as children age; it decreases precipitously by adulthood. In children in areas of endemicity, C. cayetanensis usually causes mild disease that is often asymptomatic. TMP-SMZ therapy significantly decreases the duration of oocyst excretion.
Madico
G
G
Universidad Peruana Cayetano Heredia and Asociación Benéfica PRISMA, Lima, Peru.
McDonald
J
J
Gilman
R H
RH
Cabrera
L
L
Sterling
C R
CR
D000293:Adolescent; D017677:Age Distribution; D000818:Animals; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003048:Coccidiosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000469:parasitology; D003430:Cross-Sectional Studies; D003906:Developing Countries; D003967:Diarrhea / Q000188:drug therapy* / Q000453:epidemiology* / Q000469:parasitology; D004311:Double-Blind Method; D016783:Eucoccidiida / Q000187:drug effects*; D005243:Feces / Q000469:parasitology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000627:therapeutic use*
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination