Abstract

DE LA OSSA MERLANO, Napoleón; FALCONAR, Andrew; LLINAS SOLANO, Humberto J.  and  ROMERO VIVAS, Claudia M.. Clinical manifestations and risk factors associated with Cryptosporidium spp.. infections in patients from Barranquilla and three "municipios" of Atlántico (Colombia). Salud, Barranquilla [online]. 2007, vol.23, n.1, pp.19-31. ISSN 0120-5552.

Objectives: To characterize the clinical manifestations and risk factors associated with Cryptosporidium. Materials and methods: A descriptive study was performed on 423 patients, with macroscopic and microscopic faecal sample analyses, to identify the clinical manifestations and risk factors associated with cyptosporidiosis in 3 towns and the principal city in Atlantico (Colombia) over a 4-month period. Cryptosporidium spp. oocysts were identified after staining with modified Ziehl-Neelsen. A saturated NaCl parasite-concentration method was also compared with wet-mount method for the detection of all intestinal parasites in 279/423 (66.0%) patients. Statistical analyses were performed using EPI-INFO 6.04. Results: The prevalence of Cryptosporidium spp.. was 1.9% (8/423). Statistical associations were found between Cryptosporidium infections and fever (p=0.01), blood in the faecal samples (p=0.01) and the presence of household animals (p=0.02). Most of the patients (267/423: 63.1%) were positive for intestinal parasites. The most commonly identified parasites were the non-pathogenic protozoa, Entamoeba coli (118/423: 27.9%) and Endolimax nana (86/423: 20.3%), followed by Blastocystis hominis (76/423: 18%), Entamoeba histolytica/dispar (28/423: 6.6%) and Giardia lamblia (23/423: 5.4%). Ascaris lumbricoides (6/423: 1.4%) was the most common helminth identified. Sensitivities/specificities of 99.4%/95.2% and 87.5%/99.6% were obtained for protozoa and helminths respectively using the saturated NaCl method. Conclusions: Patients with Cryptosporidium had fever and bloody faecal samples, and were probably infected by domestic animals. Microscopy, using the modified Ziehl-Neelsen stain, was essential for Cryptosporidium spp.. oocyst identification. The saturated NaCl method efficiently concentrated the parasites.

Keywords : Cryptosporidium spp; modified Ziehl-Neelsen stain; intestinal parasitesis.

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