title: Prevalence of Cryptosporidium-associated diarrhea in a high altitude-community of Saudi Arabia detected by conventional and molecular methods.
abstract: Cryptosporidium diarrhea represents a relevant clinical problem in developing countries. In Al-Taif, a city of Saudi Arabia that lies at an altitude of an around 2 km above the sea level, Cryptosporidium infection seems to be undiagnosed in nearly all clinical laboratories. Furthermore, nothing was published regarding Cryptosporidium-associated diarrhea in this area. The objectives of this research were to (1) determine the Cryptosporidium prevalence among patients with diarrhea and (2) to estimate the performances of 3 different diagnostic methods. Total 180 diarrheal fecal samples, 1 sample per patient, were collected between January and August 2013. Samples were screened for Cryptosporidium with modified Zeihl Neelsen (ZN) microscopy, RIDA® Quick lateral flow (LF) immunotest, and a previously published PCR. The Cryptosporidium prevalence rate was 9.4% (17/180), 10% (18/180), and 11.6% (21/180) by microscopy, LF, and PCR test, respectively. Infection was significantly (P=0.004) predominant among children <5 years (22%) followed by children 5-9 years (11.1%). Although infection was higher in males than in females (16.2% males and 8.5% females), the difference was not statistically significant (P=0.11). Compared to PCR, the sensitivity of microscopy and the LF test were 80.9%, 85.7%, respectively. To conclude, high Cryptosporidium-associated diarrhea was found in this area especially in children ≤9 years. The PCR test showed the best performance followed by the LF test and ZN staining microscopy. The primary health care providers in Al-Taif need to be aware of and do testing for this protozoon, particularly for children seen with diarrhea.
authors.affiliation: Department of Medical Parasitology, NLI, Menoufia University, Shebin El-Koom, Menoufia, Egypt. ; Department of Medical Laboratory Science, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.
authors.forename: Yousry
authors.initials: Y
authors.lastname: Hawash
authors.affiliation: Department of Nursing, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia. ; Department of Community Medicine, NLI, Menoufia University, Shebin El-Koom, Menoufia, Egypt.
authors.forename: Laila Sh
authors.initials: LSh
authors.lastname: Dorgham
authors.affiliation: Department of Medical Laboratory Science, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.
authors.forename: Ayman S
authors.initials: AS
authors.lastname: Al-Hazmi
authors.affiliation: Department of Medical Laboratory Science, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia.
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Al-Ghamdi
mesh_terms: D000293:Adolescent; D000328:Adult; D000531:Altitude; D002648:Child; D002675:Child, Preschool; D003457:Cryptosporidiosis / Q000453:epidemiology*; D003458:Cryptosporidium / Q000302:isolation & purification*; D003967:Diarrhea / Q000453:epidemiology / Q000469:parasitology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012529:Saudi Arabia / Q000453:epidemiology; D055815:Young Adult
keywords: Cryptosporidium; PCR; diarrhea; high altitude; lateral flow test; microscopy