title: Cyclospora Infection among School Children in Kathmandu, Nepal: Prevalence and Associated Risk Factors.
abstract: BACKGROUND
  The intestinal coccidian protozoa Cyclospora cayetanensis has emerged as an important cause of parasitic diarrhea among children living in developing countries. This study aimed to determine the prevalence of Cyclospora among the school children of Kathmandu with reference to various associated risk factors.
  
  
  METHODS
  A total of five hundred and seven stool samples from students between the age of 3-14 years, studying in 13 different schools in Kathmandu were collected during the study period (May-November, 2014) and processed at the Public Health Research Laboratory, Institute of Medicine, Kathmandu, Nepal. A modified acid fast staining technique (Kinyoun's method) was used to detect oocyst of Cyclospora from the formal-ether concentrated stool samples.
  
  
  RESULTS
  Cyclospora was detected in 3.94% (20/507) of the stool samples examined. The prevalence was found to be highest among the students in the 3-5 year age group i.e. 10.15% (13/128), peaking during the rainy season (June-August). The detection rate was found to be significantly higher (p < 0.05) among children presenting with diarrheal symptoms, household keeping livestock and consumers of raw vegetables/fruits, showing a prevalence of 10.57% (11/104), 10.11% (9/89) and 7.25% (14/193) respectively.
  
  
  CONCLUSIONS
  Consumption of untreated drinking water, fresh produce (raw fruits/vegetables) without proper washing and the presence of livestock at home were found to be predisposing factors for higher susceptibility of infection due to Cyclospora. This finding confirms the existence of a public-health issue with potentially serious consequences whereby children can be infected through exposure to oocysts in contaminated food and water and get ill as a result.
authors: Tribhuvan University Institute of Medicine, Public Health Research Laboratory and Microbiology.
authors: Dinesh
authors: D
authors: Bhandari
authors: Tribhuvan University Institute of Medicine, Public Health Research Laboratory and Microbiology.
authors: Sarmila
authors: S
authors: Tandukar
authors: Department of Microbiology, Tribhuvan University Tri-Chandra Multiple Campus.
authors: Hiramani
authors: H
authors: Parajuli
authors: Department of Microbiology, Tribhuvan University Tri-Chandra Multiple Campus.
authors: Pratigya
authors: P
authors: Thapa
authors: Department of Microbiology, Tribhuvan University Tri-Chandra Multiple Campus.
authors: Prakash
authors: P
authors: Chaudhary
authors: Department of Microbiology, Tribhuvan University Tri-Chandra Multiple Campus.
authors: Dhiraj
authors: D
authors: Shrestha
authors: Department of Microbiology, Tribhuvan University Tri-Chandra Multiple Campus.
authors: Pradeep K
authors: PK
authors: Shah
authors: Department of Clinical Microbiology, Kathmandu University School of Medical Sciences , Dhulikhel, Nepal.
authors: Jatan B
authors: JB
authors: Sherchan
authors: Tribhuvan University Institute of Medicine, Public Health Research Laboratory and Microbiology.
authors: Jeevan B
authors: JB
authors: Sherchand
keywords: Cyclospora cayetanensis; Prevalence and Kathmandu; School Children