title: Treatment and prevention of cryptosporidiosis: what options are there for a country like Zambia?
abstract: Cryptosporidiosis is a major infection of humans, leading to diarrhoea and growth failure in children, diarrhoea and malnutrition in immunocompromised adults, and is associated with increased mortality in all age groups. Using the country of Zambia as an example, I review the possible approaches to treatment and prevention in a tropical setting. The current optimal therapy for cryptosporidiosis is nitazoxanide which works well in HIV uninfected children, but treatment in patients with HIV infection remains remarkably difficult. No single drug has demonstrated efficacy in a randomised trial. No vaccine is available, so the best option for prevention for the moment is filtration and clean storage of drinking water. This would be expected to reduce cryptosporidiosis dramatically, but this needs to be demonstrated directly. Water filtration would have the added benefit of protection against many other pathogens, but the paucity of alternative approaches highlights the need for a better understanding of this important human pathogen.
authors.affiliation: Barts and The London School of Medicine, Queen Mary University of London, London. m.p.kelly@qmul.ac.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Kelly
mesh_terms: D000981:Antiprotozoal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003457:Cryptosporidiosis / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control*; D003458:Cryptosporidium / Q000187:drug effects / Q000502:physiology; D003967:Diarrhea / Q000209:etiology; D060766:Drinking Water / Q000592:standards*; D015658:HIV Infections / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D009574:Nitro Compounds; D010303:Paromomycin / Q000494:pharmacology / Q000627:therapeutic use; D013844:Thiazoles / Q000494:pharmacology / Q000627:therapeutic use; D018508:Water Purification / Q000295:instrumentation / Q000379:methods; D015024:Zambia / Q000453:epidemiology
chemical_list: D000981:Antiprotozoal Agents; D060766:Drinking Water; D009574:Nitro Compounds; D013844:Thiazoles; D010303:Paromomycin; C041747:nitazoxanide