Cryptosporidium parvum and Isospora belli infections among patients with and without diarrhoea.
OBJECTIVE
To assess the importance of Cryptosporidium parvum and Isospora belli infections as a cause of diarrhoea among patients admitted to the Medical Wards in Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi.


METHODS
Prospective case control study.


METHODS
One hundred and twenty one patients with diarrhoea and 122 patients without diarrhoea.


METHODS
Demonstration of C. parvum and I. belli oocysts by examination of at least one stool sample per patient using phenol auramine-O-fluorescence staining and an immuno-fluorescent assay with monoclonal antibodies against Cryptosporidium, seropositivity for HIV and AIDS.


RESULTS
In 22% of the patients with diarrhoea an infection with C. parvum or I. belli was found. Thirteen (11%) of them had a C. parvum and 14 (12%) an I. belli infection; a mixed infection was found in one patient. In the control group, three (3%) C. parvum and three (3%) I. belli infections were seen. The prevalence of both infections was very significantly higher in the cohort of diarrhoea patients than in the controls, 13/108 versus 3/119 (p=0.0099) for C. parvum, and 14/107 versus 3/119 (p=0.0056) for I. belli. Infections were only seen in HIV positive patients. Two hundred and four (84%) patients were HIV positive and 145 (60%) of them had AIDS.


CONCLUSIONS
C. parvum and I. belli infections are a significant cause of diarrhoea among medical in-patients at QECH. Examinations of stool specimen for parasites among hospitalised patients with diarrhoea provide data for a more appropriate management.
Department of Medical Microbiology, and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, PO Box 2060, NL-3000 CB Rotterdam, The Netherlands.
R J
RJ
Cranendonk
C J
CJ
Kodde
D
D
Chipeta
E E
EE
Zijlstra
J F
JF
Sluiters
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000818:Animals; D016022:Case-Control Studies; D003457:Cryptosporidiosis / Q000453:epidemiology*; D016785:Cryptosporidium parvum / Q000302:isolation & purification*; D003967:Diarrhea / Q000469:parasitology*; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D007549:Isospora / Q000302:isolation & purification*; D021865:Isosporiasis / Q000453:epidemiology*; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010270:Parasite Egg Count; D011446:Prospective Studies