title: Marked seasonality of Cyclospora cayetanensis infections: ten-year observation of hospital cases, Honduras.
abstract: BACKGROUND
  Document seasonality occurrence and epidemiologic characteristics of Cyclospora cayetanensis infections during a 10-year period from patients consulting at the University Hospital, Honduras.
  
  
  METHODS
  Retrospective non interventional hospital-based study analyzed laboratory results from the period 2002 to 2011 of fresh and Ziehl-Nielsen carbolfuchsin stained routine stool samples received for parasitologic examination. Sporadically a sample with numerous oocysts was allowed to sporulate in 2.5 % potassium dichromate confirming the presence of bi-cystic bi-zoic oocysts.
  
  
  RESULTS
  A total of 35,157 fecal samples were examined during a ten-year span, of which a third (28.4 %) was stained by the Ziehl-Neelsen carbolfuchsin method diagnosing a total of 125 (1.3 %) C.cayetanensis infections. A statistically significant apparent seasonality was observed most years during May to August (range p < 0.036-0.001), with 83.3 % of 125 cases occurring in those rainy months. All C. cayetanensis cases came from urban poor neighborhoods; male/female relation was 1:1 except in 2006, when all patients were females (p = 0.05; r(2) = 22,448). Forty four point eight percent of the stool samples were diarrheic or liquid and 65.6 % infections were identified in children 10 years old or less. Enteric helminths and protozoa co-infected Cyclospora positive patients in 52 instances.: 8 % Ascaris lumbricoides, 8 % Giardia duodenalis, 23.2 % Blastocystis spp. and less frequently Entamoeba histolytica/E. dispar, Strongyloides stercoralis, and Trichuris trichiura.
  
  
  CONCLUSIONS
  Results suggest a seasonal pattern for Cyclospora infections diagnosed in a clinical setting during the rainy months in Tegucigalpa and surrounding areas. Community studies should be conducted to support or dispute these observations.
authors: Pediatric Department, School of Medical Sciences, National Autonomous University of Honduras and Parasitology Service, University Hospital, Tegucigalpa, Honduras. camilaestela12@yahoo.com.
authors: Rina Girard
authors: RG
authors: Kaminsky
authors: School of Medical Sciences, National Autonomous University, Honduras, Barrio Villa Adela, Casa No. 2453, Comayagüela, Honduras. javierlagos16@gmail.com.
authors: Javier
authors: J
authors: Lagos
authors: School of Medical Sciences, National Autonomous University, Honduras, Hospital Santa Teresa, Comayagua, Honduras. gaby_schm7@hotmail.com.
authors: Gabriela
authors: G
authors: Raudales Santos
authors: School of Medical Sciences, National Autonomous University, Honduras, Barrio El Calvario, Casa No. 585, Santa Rosa de Copán, Honduras. sam537urrutia@gmail.com.
authors: Samuel
authors: S
authors: Urrutia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology / Q000469:parasitology; D021744:Cyclospora / Q000302:isolation & purification*; D021866:Cyclosporiasis / Q000453:epidemiology* / Q000469:parasitology; D005243:Feces / Q000469:parasitology; D005260:Female; D006376:Helminths / Q000302:isolation & purification; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012621:Seasons; D055815:Young Adult