Longitudinal Study of Cryptosporidium Infection in Children in Northeastern Brazil

A prospective, 4-year cohort study of children born in an urban slum in northeastern Brazil was undertaken to elucidate the epidemiology of Cryptosporidium infection in an endemic setting, describe factors associated with Cryptosporidium-associated persistent diarrhea, and clarify the importance of...

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Bibliographic Details
Published in:The Journal of infectious diseases 1999-07, Vol.180 (1), p.167-175
Main Authors: Newman, Robert D., Sears, Cynthia L., Moore, Sean R., Nataro, James P., Wuhib, Tadesse, Agnew, Deborah A., Guerrant, Richard L., Lima, Aldo A. M.
Format: Article
Language:English
Subjects:
Analysis of Variance
Biological and medical sciences
Brazil
Brazil - epidemiology
Child nutrition
Cryptosporidiosis
Cryptosporidiosis - epidemiology
Cryptosporidium
Developing Countries
Diarrhea
Diarrhea - epidemiology
Diseases
Epidemiology
Escherichia coli
Feces - parasitology
Female
Human protozoal diseases
Humans
Infant
Infant, Low Birth Weight
Infant, Newborn
Infections
Infectious diseases
Longitudinal Studies
Major Articles
Male
Medical sciences
Nutritional Status
Oocysts
Parasitic diseases
Poverty Areas
Protozoal diseases
Recurrence
Risk Factors
Seasons
Slums
Tropical medicine
Urban Population
Z score
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Summary:A prospective, 4-year cohort study of children born in an urban slum in northeastern Brazil was undertaken to elucidate the epidemiology of Cryptosporidium infection in an endemic setting, describe factors associated with Cryptosporidium-associated persistent diarrhea, and clarify the importance of copathogens in symptomatic cryptosporidiosis. A total of 1476 episodes of diarrhea, accounting for 7581 days of illness (5.25 episodes/child-year), were recorded: of these, 102 episodes (6.9%) were persistent. Cryptosporidium oocysts were identified in 7.4% of all stools, and they were found more frequently in children with persistent diarrhea (16.5%) than in those with acute (8.4%) or no (4.0%) diarrhea (P < .001). Low-birth-weight children and those living in densely crowded subdivisions were at greater risk for symptomatic infection. Disease course was highly variable and was not associated with the presence of copathogens. Recurrent Cryptosporidium infection and relapsing diarrhea associated with it were moderately common. In light of these data, the applicability of the current World Health Organization diarrheal definitions to Cryptosporidium-associated diarrheal episodes may need to be reconsidered.
ISSN:0022-1899
1537-6613
DOI:10.1086/314820