SURVEY OF HOUSE RAT INTESTINAL PARASITES FROM SURABAYA DISTRICT, EAST JAVA, INDONESIA THAT CAN CAUSE OPPORTUNISTIC INFECTIONS IN HUMANS.

The purpose of this study was to investigate the prevalence of house rat zoonotic intestinal parasites from Surabaya District, East Java, Indonesia that have the potential to cause opportunistic infection in humans. House rat fecal samples were collected from an area of Surabaya District with a dense rat population during May 2015. Intestinal parasites were detected microscopically using direct smear of feces stained with Lugol's iodine and modified Ziehl-Neelsen stains. The fecal samples were also cultured for Strongyloides stercoralis. Ninety-eight house rat fecal samples were examined. The potential opportunistic infection parasite densities found in those samples were Strongyloides stercoralis in 53%, Hymenolepis nana in 42%, Cryptosporidium spp in 33%, and Blastocystis spp in 6%. This is the first report of this kind in Surabaya District. Measures need to be taken to control the house rat population in the study area to reduce the risk of the public health problem. Keywords: zoonotic intestinal parasites, opportunistic infection, house rat, densely populated area, Indonesia

[Progress on the application of Cryptosporidium infected animal models and in vitro cultivation].

The genus Cryptosporidium is composed of protozoan parasites that infect epithelial cells in the microvillus border of the gastrointestinal tract of all classes of vertebrates, and cause severe diarrheal disease in a variety of neonatal animals, children and immunocompromised persons. Establishment of Cryptosporidium infected animal models and its in vitro cultivation system have established a good foundation for characterizing life cycle stage, exploring immunological mechanism, developing vaccines, screening and evaluating potential drugs, as well as assessing oocyst inactivation techniques. This paper reviews recent development and application of the Cryptosporidium infected animal models and its in vitro cultivation.

A One Health Approach to Tackle Cryptosporidiosis.

Cryptosporidiosis is a significant diarrhoeal disease in both people and animals across the world and is caused by several species of the protozoan parasite Cryptosporidium. Recent research has highlighted the longer-term consequences of the disease for malnourished children, involving growth stunting and cognitive deficits, and significant growth and production losses for livestock. There are no vaccines currently available to prevent the disease and few treatment options in either humans or animals, which has been a significant limiting factor in disease control to date. A One Health approach to tackle zoonotic cryptosporidiosis looking at new advances in veterinary, public, and environmental health research may offer several advantages and new options to help control the disease.

Interaction between human mucins and parasite glycoproteins: the role of lectins and glycosidases in colonization by intestinal protozoa.

Intestinal mucins are the first line of defense against microorganisms. Although knowledge about the mechanisms involved in the establishment of intestinal protozoa is limited, there is evidence that these parasites produce lectin-like molecules and glycosidases, that exert both, constitutive and secretory functions, promoting the establishment of these microorganisms. In the present review, we analyse the main interactions between mucins of the host intestine and the four main protozoan parasites in humans and their implications in intestinal colonization. There are lectin-like molecules that contain complex oligosaccharide structures and N-acetylglucosamine (GlcNAc), mannose and sialic acid as main components, which are excreted/secreted by Giardia intestinalis, and recognized by the host using mannose-binding lectins (MBL). Entamoeba histolytica and Cryptosporidium spp. express the lectin galactose/N-acetyl-D-galactosamine, which facilitates their adhesion to cells. In Cryptosporidium, the glycoproteins gp30, gp40/15 and gp900 and the glycoprotein lectin CpClec are involved in protozoan adhesion to intestinal cells, forming an adhesion-attack complex. G. intestinalis and E. histolytica can also produce glycosidases such as ß-N-acetyl-D-glucosaminidase, α-d-glucosidase, ß-d-galactosidase, ß-l-fucosidase, α-N-acetyl-d-galactosaminidase and ß-mannosidase. In Blastocystis, α-D-mannose, α-D-glucose, GlcNAc, α-D-fucose, chitin and sialic acid that have been identified on their surface. Fucosidases, hexosaminidases and polygalacturonases, which may be involved in the mucin degradation process, have also been described in the Blastocystis secretoma. Similarly, symbiotic coexistence with the intestinal microbiota promotes the survival of parasites facilitating cell invasion and nutrients obtention. Furthermore, it is necessary to identify and characterize more glycosidases, which have been only partially described by in silico analyses of the parasite genome.

Association of Cryptosporidium with bovine faecal particles and implications for risk reduction by settling within water supply reservoirs.

Artificial cow pats were seeded with Cryptosporidium oocysts and subjected to a simulated rainfall event. The runoff from the faecal pat was collected and different particle size fractions were collected within settling columns by exploiting the size-dependent settling velocities. Particle size and Cryptosporidium concentration distribution at 10 cm below the surface was measured at regular intervals over 24 h. Initially a large proportion of the total volume of particles belonged to the larger size classes (> 17 microm). However, throughout the course of the experiment, there was a sequential loss of the larger size classes from the sampling depth and a predominance of smaller particles (< 17 microm). The Cryptosporidium concentration at 10 cm depth did not change throughout the experiment. In the second experiment samples were taken from different depths within the settling column. Initially 26% of particles were in the size range 124-492 microm. However, as these large particles settled there was an enrichment at 30 cm after one hour (36.5-49.3%). There was a concomitant enrichment of smaller particles near the surface after 1 h and 24 h. For Pat 1 there was no difference in Cryptosporidium concentration with depth after 1 h and 24 h. In Pat 2 there was a difference in concentration between the surface and 30 cm after 24 h. However, this could be explained by the settling velocity of a single oocyst. The results suggested that oocysts are not associated with large particles, but exist in faecal runoff as single oocysts and hence have a low (0.1 m(d-1)) settling velocity. The implications of this low settling velocity on Cryptosporidium risk reduction within water supply reservoirs was investigated through the application of a three-dimensional model of oocyst fate and transport to a moderately sized reservoir (26 GL). The model indicated that the role of settling on oocyst concentration reduction within the water column is between one and three orders of magnitude less than that caused by advection and dilution, depending on the strength of hydrodynamic forcing.

Evaluating Cryptosporidium and Giardia concentrations in combined sewer overflow.

Since the first identified Cryptosporidium outbreaks occurred in the 1980s and the massive 1993 Milwaukee, WI outbreak affected more than 400,000 people, the concern over the public health risks linked to protozoan pathogens Cryptosporidium and Giardia has grown. Cryptosporidium and Giardia, found in streams, rivers, groundwater, and soil, form hardy, disinfection-resistant oocysts and cysts. Both organisms are recognized causative agents of gastrointestinal illnesses linked to the consumption of contaminated surface or groundwater. This study, the first in a planned series to estimate the urban contribution to the total Cryptosporidium and Giardia receiving-water loads, focused on combined sewer overflow (CSO). CSOs are discharges of mixed untreated sewage and stormwater released directly into receiving waters during rainfall. This engineered relief is necessary to accommodate hydraulic strain when the combined rain and sanitary flows exceed the system capacity. Limited comprehensive data are available assessing the CSO discharge contribution as a source of these two pathogens. Works by States et al. and Gibson et al. each found Cryptosporidium and much greater Giardia concentrations in CSOs draining parts of Pittsburgh, PA. This project estimated the relative detection frequency and concentration of Cryptosporidium and Giardia in CSO. Analytical results were obtained using a modification of Method 1623, originally developed for much cleaner environmental samples. These data are useful for drinking water treatment plants located downstream of CSOs. It is also significant in determining the potential concentrations of parasites at treatment plant intakes and for assessing health risks for water contact and fishing activities. Commonly monitored indicator organisms (total coliform, fecal coliform, E. coli, Enterococcus, and fecal streptococcus), endospores, and selected physical and chemical parameters were analyzed to further describe the samples. CSO from urban areas was not found to be a significant contributor of Cryptosporidium, however, it was found to be a Giardia source.

Occurrence and molecular identification of Cryptosporidium spp. in dairy calves in Xinjiang, Northwestern China.

A total of 514 fecal samples were collected from dairy calves on 15 farms in the Xinjiang Uyghur Autonomous Region in Northwestern China and were screened for Cryptosporidium spp. by PCR. The overall prevalence of Cryptosporidium was 16.0% (82/514), and the infection rate was 15.6% (37/237) and 16.2% (45/277) in pre- and post-weaned calves, respectively. PCR-restriction fragment length polymorphism (RFLP) and DNA sequence analyses of 82 positive fecal samples revealed the presence of four Cryptosporidium species; of these, 22 were Cryptosporidium parvum, 20 were Corynebacterium bovis, 9 were Cryptosporidium ryanae, 25 were Cryptosporidium andersoni, 2 were mixed C. bovis/C. parvum, and 4 were mixed C. bovis/C. ryanae infections. In pre-weaned calves, C. parvum was the most common species (22/37, 59.5%). In contrast, C. andersoni was the dominant species (23/45, 51.1%) in post-weaned calves. Subtyping analysis based on the 60-kDa glycoprotein (gp60) gene successfully identified 15 C. parvum isolates as being in the IId family; 11 were IIdA15G1 and 4 were IIdA14G1. Recent findings describing the C. parvum IId subtypes as the dominant group in humans and animals in China indicate that dairy calves may be an important source of zoonotic Cryptosporidium in China.

[Prevalence of Cryptosporidium sp and Isospora belli in patients with acquired immunodeficiency syndrome (AIDS) in Dakar (Senegal]. / Prévalence de Cryptosporidium sp et d'Isospora belli chez des patients atteints du syndrome d'immunodéficience acquise (SIDA) à Dakar (Senegal).

72 patients with AIDS, having diarrhoea and admitted in the Unit of Infectious diseases, Fann Hospital from 1989 to 1991 were investigated for Cryptosporidium sp. and Isospora belli isolation by the modified Ziehl-Neelsen technique, after stolls' concentration by Ritchie technique. The prevalence were 13.9% for Cryptosporidium sp, and 15.3% for I. belli. In two patients (2.8%), these 2 coccidiae were associated. Cryptosporidium sp. and I. belli were the single parasites found respectively in 6 (8.3% and 7 (9.7%) of the patients. In the other faecal samples with a positive result for Cryptosporidium sp. or I. belli, they were associated with A. lumbricoides, G. intestialis, E. histolytica or S. stecoralis. According to these results, Cryptosporidium sp. and I. belli were more frequently observed in AIDS patients from Dakar than those from Zaire, Congo and Côte d'Ivoire.

Cryptosporidium spp. e Giardia spp. em carnívoros silvestres do Estado do Pará ­ Brasil / Cryptosporidium spp. and Giardia spp. in wild carnivorous animals the State of Pará ­ Brazil

O presente estudo investigou a ocorrência de Cryptosporidium spp. e Giardia spp. em diferentes espécimes silvestres da ordem Carnívora de vida livre e de cativeiro procedentes de municípios do Estado do Pará. Coletou-se amostras fecais de 37 animais distintos (quatro de vida livre e 33 de cativeiro). Para pesquisa de Cryptosporidium spp. e Giardia spp. foram utilizados métodos microscópicos (direto e Kinyoun) e imunológico (RIDA®QUICK Cryptosporidium/Giardia/Entamoeba Combi - N1722). Do total de amostras, 24,32% (9/37) foram positivas, correspondendo a 5,4% (2/37) para Cryptosporidium spp. e 18,91% (7/37) para Giardia spp., respectivamente. Nenhum animal apresentou infecção concomitante para os agentes. Cryptosporidium spp. e Giardia spp., são protozoários zoonóticos que representam um emergente problema de saúde pública. Esses parasitos podem apresentar elevada frequência em regiões em que as condições de saneamento básico são precárias, promovendo surtos de diarreia em animais domésticos, silvestres e no homen. Mamíferos silvestres, como os carnívoros, são susceptíveis à contaminação por enteroparasitas presentes tanto no habitat natural como em cativeiro. Portanto, a pesquisa comprova a presença desses protozoários em carnívoros silvestres, tanto mantidos em criatórios como nos de vida livre no Estado do Pará, considerando-se que esses animais podem atuar como fontes de infecção para o homem, para outros animais e para o meio ambiente.

The presente survey has had the purpose to investigate the occurrance of Cryptosporidium spp. and Giardia spp. in free and under captivity carnivorous wild animals, from several counties in the State of Pará. Samples of feces from 37 distinct animals (four in their natural habitat and 33 raised in captivity). For the research of Cryptosporidium spp. and Giardia spp. microscopic immunological, direct and Kinyoun methods were used (RIDA®QUICK Cryptosporidium/Giardia/Entamoeba Combi - N1722). The samples gathered from wild animals have resulted in 24,32% of positive infecction on the rate of (9/37), being. 5,4% (2/37) positive to Cryptosporidiumspp. and 18,91% (7/37) positive to Giardia spp., what shows that no amimals had both infections at the same time. Cryptosporidium spp. and Giardia spp., are zoonotic enteroparasites that have been taking place as an emmerging problem to public health. Theese species of protozoa may reach high levels of frequency in regions where the basic sanitation conditions are precarious, promoting outbraks of diarrhea to men, wild and domestic animals. Wild mammals, as the carnivorous, are susceptible to contamination by enteroparasites, being present at their natural habitat or captivity. So, the reserach strenghtens the real presence of these protozoas in wild carnivorous in both conditions of life, free or under captivity, in the State of Pará, making us consider the possibility that the cited animals may be natural reservoirs for infections, not only to men but to other animals and also to environment.

Ocorrência de Cryptosporidium spp. em dois centros de treinamento de equinos de Curitiba, Paraná / Occurrence of Cryptosporidium spp. in two centers of training horses in Curitiba, Paraná

O presente trabalho investigou a ocorrência de parasitismo por Cryptoporidium spp. em equinos alojados em dois centros de treinamento de equinos localizados no municipio de Curitiba, Paraná. Foram examinados 108 cavalos, sendo 48 procedentes do Centro de treinamento 1 (CT1) e 60 do Centro de Treinamento 2 (CT2). As coletas de amostras de fezes foram realizadas no período de outubro de 2010 a janeiro de 2011. A metodologia utilizada para a confirmação da presença de oocistos de Cryptosporidium spp. foi a técnica de Ziehl-Neelsen modificada. A ocorrência encontrada foi de 18,52% para o total de animais examinados. Houve diferença estatística significativa (p > 0,05) quando comparadas as prevalências encontradas nos dois centros de treinamento, sendo no CT1 de 4,16% e no CT2 de 30%. Não houve associação entre a prevalência e a idade, o sexo e raça (p > 0,05).

This study investigated the occurrence of parasitism by Cryptosporidium spp. in horses housed in two training centers located in Curitiba, Paraná. A total of 108 horses were examined, 48 from the Training Center 1 (CT1) and 60 of the Training Centre 2 (CT2). Collection of stool specimens occurred from October 2010 to January 2011. The methodology used to confirm the presence of Cryptosporidium spp. was the Ziehl-Neelsen modified. The occurrence found was 18.52% for the total animals examined. There was a statistically significant difference (p > 0.05) comparing prevalence rates in the two training centers: 4.16% in CT1 and 30% in CT2. There was no association between prevalence and the age, sex and race (p > 0.05) of the horses.

Investigación de blastocystis spp, giardia spp y cryptosporidium spp en aguas de consumo en una comunidad de Caracas- Venezuela: Reporte preliminar / Surveillance of blastocystis spp, giardia spp and cryptosporidium spp in human consumption water in a community of Caracas- Venezuela

Uno de los mecanismos de transmisión de protozoarios intestinales, es el consumo de agua contaminada con quistes y ooquistes, cuya eliminación por cloración o filtración no resulta eficaz. En una comunidad de Caracas, se evaluó la posible contaminación del agua de consumo, con Blastocystis spp, Giardia spp y Cryptosporidium spp. El sedimento obtenido mediante filtración y separación inmunomagnética de 15 muestras de agua, se examinó microscópicamente al fresco, con coloraciones, inmunofluorescencia y cultivo en medio de Boeck- Drbohlav modificado (BDM). Se recopiló información sobre las condiciones de suministro, almacenamiento y consumo del agua, además del procedimiento utilizado para el lavado de frutas y vegetales. El único parásito observado fue Blastocystis spp (60%), mediante examen directo/cultivo (33%). Se observó un mayor consumo de agua filtrada que hervida (p= 0,001). Predominó el uso del agua de chorro para el lavado de vegetales y frutas, más que con agua y vinagre (p= 0,011). Se observó una mayor proporción de averías en los sistemas de recolección de aguas servidas (78,6%), más que en los sistemas de aguas blancas (28,6%, p= 0,011). El hallazgo de Blastocystis spp en el agua, se correlaciona con la prevalencia del parásito en habitantes de este sector. Destaca el papel del agua en la transmisión de Blastocystis spp, por lo cual se recomienda filtrarla y hervirla para prevenir la infección con este parásito.

Many intestinal protozoa are transmitted by contaminated water with cysts and oocysts and methods for their elimination as filtration or chlorination are not completely effective. We evaluated a possible consumption water contamination with Blastocystis spp, Giardia spp and Cryptosporidium spp in a community located in Caracas, Venezuela. The pellet obtained by immunomagnetic separation filtration of 15 water samples were examined by microscopic observation (direct examination), stain techniques, immunofluorescence and culture in Drbohlav Boeck-modified medium (BDM). We also collected information about consuming habits, water supply, storage and washing procedures of vegetables and fruits at assessed homes. The only parasite detected was Blastocystis spp (60%), by direct examination/culture (33%). A higher consumption of boiled filtered water (p = 0.001) was observed. The use of tub water for washing vegetables and fruits was predominant, instead of using water and vinegar (p = 0.011). We observed a higher proportion of nonfunctioning sewage collection (78.6%), rather than white water systems (28.6%, p = 0.011). Finding Blastocystis spp in water samples correlates with prevalence of this parasite in residents of this sector. The role of water in Blastocystis spp transmission is significant, so we recommend filtering and boiling it to prevent infection with this parasite.

Análise da prevalência de cryptosporidium spp. Em animais de companhia de idosos. Estudo de caso: Teresópolis, Rio de Janeiro, Brasil / Análisis de prevalencia de cryptosporidium spp. En animales de compañía de mayores. Estudio de caso: Teresópolis, Rio de Janeiro, Brasil / Analysis of the prevalence of cryptosporidium spp in companion animals of elderly people Case study: Teresópolis, Rio de Janeiro, Brazil

A criptosporidiose é uma importante zoonose responsável por manifestações clínicas de diarreias e gastrenterites associadas à dor abdominal, em seres humanos e animais domésticos, causada por protozoários oportunistas do gênero Cryptosporidium. Foi pesquisadaa prevalência de criptosporidiose em gatos domésticos de companhia de idosos (acima de 60 anos de idade) de ambos os sexos, residentes no município de Teresópolis, Rio de Janeiro, e que compareceram a um posto de vacinação do município no período da vacinação contra gripe de 2009 e 2010. Foi realizada uma análise univariada e uma regressão logísticaincondicional. Como instrumentos de coleta de dados foram utilizados o questionário e a coleta de amostras fecais das pessoas participantes e de seus felinos. Os resultados apontaram que a prevalência de diarreia nos idosos foi 29,4por cento e, nos felinos, 24,5por cento. Foi identificada presença de 1 ou mais oocistos em 16,7por cento dos idosos e 12,7por cento dos felinos. A análise da razão de prevalência de diarreia evidenciou uma forte associação em idosos (RP igual 4,37, IC a 95por cento: 2,67-7,16), porém com menor força de associação, mas ainda com significância estatística para felinos (RP igual 2,16, IC a 95por cento: 1,06-4,39). Por imunofluorescência confirmada pelo PCR houve semelhante força de associação em idosos (RP igual 4,43, IC a 95por cento: 3,04-6,45), porém observou-se um aumento na força de associação para felinos (RP igual 4,67, IC a 95por cento: 3,9-6,81). Concluiu-se que são preocupantes, mas importantes para a saúde pública, os achados desta pesquisa, por demonstrarem a relação zoonótica do Cryptosporidium spp. presente nas amostras fecais dos animais de companhia do grupo populacional de idosos estudados.

Cryptosporidiosis is an important zoonosis responsible for clinical signs ofdiarrhea and abdominal pain associated with gastroenteritis in humans and domestic animals caused by opportunistic protozoa of the genus Cryptosporidium. It was investigated the prevalence of cryptosporidiosis in domestic cats in companion of elderly (over 60 years of age)of both sexes, residents in Teresópolis, Rio de Janeiro, who attended a vaccination post in the municipality during the period of vaccination against influenza in 2009 and 2010. Unvaried analysis and unconditional logistic regression were performed. The data collection instrumentsused were the questionnaire and the collection of fecal samples from the people participating and from their cats. Results showed the prevalence of diarrhea in the elderly was 29.4percent and 24.5percent in cats. It was identified the presence of one or more oocytes in 16.7percent of elderly and 12.7percent in cats. The prevalence of diarrhea showed a strong association in the elderly (PR equal 4.37, 95percent CI: 2.67 to 7.16), but lower strength of association, but still statistically significant for felines (PR equal 2.16, 95percent CI: 1.06 to 4.39). For immunofluorescence confirmed by PCR was similar strength of association in the elderly (PR equal 4.43, 95percent CI: 3.04 to 6.45), but there was an increase in the strength of association for cats (PR equal 4.67, 95percent CI: 3.9 to 6.81). It was concluded that the findings of this research are disturbing, although very important to public health, for demonstrating the relationship of zoonotic Cryptosporidium spp. present in fecalsamples of companion animals from the elderly people studied.

La criptosporidiosis es una zoonosis importante responsable por las manifestaciones clínicas de diarrea y gastroenteritis asociadas al dolor abdominal, en seres humanos y animales domésticos, causadas por protozoos del género Cryptosporidium oportunista. Se investigó laprevalencia de la infección en gatos domésticos de compañía de personas mayores (con más de 60 años de edad) de ambos sexos, residentes en el municipio de Teresópolis, Rio de Janeiro, y que comparecieron al centro de vacunación del municipio, durante el período de vacunación contra la influenza de 2009 a 2010. Se realizó un análisis univariada y una regresión logística incondicional. Como instrumentos de recolección de datos se utilizó el cuestionario y muestras de heces delas personas participantes y de sus felinos. Los resultados mostraron la prevalencia de diarrea en mayores fue de 29,4por ciento y 24,5por ciento en los felinos. Fue identificada la presencia de uno o más quistes en 16,7por ciento de los mayores y 12,7por ciento en los felinos. El análisis de la razón de prevalencia de diarrea mostró una fuerte asociación en mayores (RP igual 4,37, IC a 95por ciento: 2,67 a 7,16), pero con menor fuerza de asociación, pero estadísticamente significativa para los felinos (RP igual 2,16, IC a 95por ciento: 1,06 a 4,39). Por imunofluorescência confirmada por el PCR hubo semejante fuerza de asociación en mayores (RP igual 4.43, IC a 95por ciento: 3,04-6,45), pero, se observó un aumento en la fuerza de asociación para los felinos (PR igual 4, 67, IC a 95por ciento: 3,9-6,81). Se concluye que los resultados deesta investigación son preocupantes, pero importantes para la salud pública, por demostrar la relación de enfermedades zoonóticas de Cryptosporidium spp. presentes en las muestras fecales de animales de compañía de la población de mayores estudiados.

Parasitologia ambiental: métodos de concentração e detecção de Cryptosporidium spp. e Giardia spp. em amostras de água / Environmental parasitology: methods of concentration and detection of Cryptosporidium spp. and Giardia spp. in water samples

A transmissão de protozoários patogênicos pela água é um dos mais relevantes problemas de saúde pública na atualidade. Numerosos surtos epidêmicos causados pelos protozoários Giardia e Cryptosporidium ocorreram ao redor do mundo em passado recente. Entretanto, os métodos utilizados para a detecção de cistos e oocistos em amostras de água são influenciados porcaracterísticas físico-químicas da matriz de água, como a turbidez. Esta revisão apresenta uma análise crítica das diferentes metodologias de concentração de cistos de Giardia e de oocistos de Cryptosporidium em amostras de águas destinadas ao consumo humano. A implantação domonitoramento desses protozoários é uma necessidade no Brasil dada a recente revisão da Portarianúmero 518 do Ministério da Saúde.

Infestación por Cryptosporidium Spp e Isospora Belli en preescolar inmunocompetente: a propósito de un caso / Infestation by Crytosporidium Spp and Isospora belli in immunocompetent preschool: a report of a case

El Cryptosporidium spp e Isospora belli son parásitos emergentes, que representan la cuarta causa de diarrea a nivel mundial, principalmente en niños y en pacientes inmunocomprometidos. Producen diarrea aguda o crónica dependiendo de la edad del paciente, estado nutricional e inmunológico asociado a factores sanitarios desfavorables. El diagnostico se realiza por visualización directa en heces con tinción de Zelh Neelsen modificado o Kinyou y biopsia intestinal con presencia de protozoos en las criptas y atrofia vellositaria de acuerdo al grado de infestación. Se reporta el caso de preescolar de 2 años de edad, eutrófico e inmunocompetente, perteneciente a estrato social bajo; con episodios de diarreas acuosas autolimitadas, dolor y distensión abdominal frecuentes. La biopsia intestinal revelo atrofia vellositaria e infestación simultanea por Cryptosporidium spp e Isospora belli corroborado por Tinción de Kinyou en heces; se descarto además Alergia Alimentaria, Enfermedad Celiaca e Inmunodeficiencias. El propósito de este caso clínico es alertar sobre la necesidad de incluir dentro del protocolo de estudio de diarrea crónica, la búsqueda de protozoarios formadores de esporas, mediante tinción especial en heces; un método no invasivo y sencillo, no solicitado en forma rutinaria.

Cryptosporidium spp and Isospora belli parasites are emerging that represent the fourth leading cause of diarrhea worldwide, mainly in children and in immunocompromised patients. Acute or chronic diarrhea occur depending on the patient's age, nutritional status and immunological factors associated with adverse health. The diagnosis is made by direct visualization in feces Neelsen stain Zelh Kinyou modified or intestinal biopsy and the presence of protozoa in the crypts and villous atrophy according to the degree of infestation. We report the case of preschool age 2, eutrophic immunocompetent, belonging to low socioeconomic levels, with self-limiting episodes of acute watery diarrhea, frequent abdominal pain and bloating. The intestinal biopsy revealed villous atrophy and simultaneous infestation by Cryptosporidium spp and Isospora belli Kinyou confirmed by staining in feces, while discarding also Food Allergy, Celiac disease and immunodeficiencies. The purpose of this case to alert about the need to include in the study protocol of chronic diarrhea, the search for spore-forming protozoa by special staining in feces, a noninvasive and simple method, not routinely requested.

Nuevos y viejos agentes asociados a diarrea en niños en Honduras / New and old agents of acute diarrhea In children In Honduras

INTRODUCCIÓN: La diarrea es la segunda causa de morbilidad y mortalidad en niños menores de 5 años en Honduras. El objetivo de este estudio fue determinar los agentes etiológicos virales, bacterianos y parasitarios en niños con diarrea no sanguino lenta de 2 barrios marginales de Comayagüela, Honduras. METODOLOGÍA: Estudio de casos y controles realizado del 1er de marzo al 31 de agosto 2004 en los centros de Salud de Las Crucitas y El Carrizal, en 151 niños de 6 meses a 5 años de edad con diarrea aguda que acudieron por demanda espontanea; con los correspondientes 151 controles apareados por edad, sexo y vecindario, una vez obtenido el consentimiento informado. Las muestras de heces se procesaron por virus, bacterias y parásitos utilizando métodos convencionales en el laboratorio. El análisis estadístico además de la prueba exacta de Fisher. RESULTADOS: Se encontró una asociación significativa entre los niños infectados por Cryptosporidium spp. y Adenovirus y los episodios de diarrea aguda, comparada con los no infectados por esos agentes patógenos (OR=9.31, 95%CI=1.24 - 69.97; OR = 5.47, 95%CI=1.51 – 19.80, respectivamente); los 8 pacientes infectados con Rotavirus tenían un cuadro diarreico agudo evidente (prueba exacta de Fisher p<0.01). CONCLUSIONES: Las infecciones por Adenovirus, Rotavirus y Cryptosporidium spp. se asociaron fuertemente con diarrea aguda no sanguinolenta en niños en Honduras...

Cryptosporidium SPP: en niños sanos menores de 10 años de la comuna 18 de Cali, Colombia / Cryptosporidium spp. in healthy children under 10 years of the Commune 18, Cali, Colombia

Introducción: El Cryptosporidium spp. (C. spp.) es uno de los principales agentes causales de diarrea enniños. En Colombia, hay pocos estudios de prevalencia en niños sanos. Objetivo: Determinar la prevalencia de C. spp. mediante ELISA en niños de Cali, Colombia. Materiales y métodos: Estudio descriptivo observacional de corte transversal en 107 niños sanos < 10 años, de la Comuna 18 de Cali, Colombia, quienes consultaron al Programa de Crecimiento y Desarrollo del Centro de Salud Lourdes. El análisis estadístico incluyó medidas de tendencia central, de dispersión y pruebas de asociación. Se incluyeron datos como edad, género, signos y síntomas, peso (P) y talla (T), y condiciones ambientales. Según las tablas de la NCHS fueron clasificados según grado de desnutrición (DNT). La identificación del C. spp., se realizó en materia fecal mediante la técnica de ELISA. Resultados: Fueron analizados 100 niños, 66% estrato 1, con edad = 4 años ± 2 meses, 50 niños, 30% en hacinamiento, 95% con agua potable, 85% con disposición de excretas, 52% con animales intradomiciliares, y 63% asisten a guardería o colegio. Ninguno de los niños C. spp. positivos, presentó síntomas. Tuvieron P = 16±6 kg y T = 97±18 cm, 40% con algún tipo de DNT. La prevalencia fue del 4% (IC 95% 0,1-7,89) sin diferencias significativas (p>0.05). Conclusiones: La prevalencia para C. spp. fue del 4% sin posibles asociaciones demográficas, ambientales o clínicas.

Introduction: Cryptosporidium spp. (C. spp.) is a major causative agents of diarrea in children. In Colombia, there are few prevalence studies in healthy children. Objective: To determine the prevalence ofC. spp. by ELISA in children of Cali, Colombia. Materials and methods: A cross-sectional observational in 107 healthy children < 10 years from the Commune 18 in Cali, Colombia, who consulted the Growth and Development Program of Centro de Salud Lourdes. Statistical analysis included measures of central tendency, dispersión and association tests. Data included age, gender,signs and symptoms, weight (W) and height (H), and environmental conditions. According to the NCHS tables were classified by degree of malnutrition (MNT). The identification of C. spp. was held in stool by ELISA. Results: 100 children were analyzed, 66% stratum 1, age = 4 years ± 2 months, 50 boys, 30% overcrowding, 95% with wáter, 85% with waste disposal, 52% with home animals, and 63% attend daycare or school. None of the children C. spp. positive had symptoms. The W were 16±6 kg and H were 97±18 cm, 40% were some form of MNT. The prevalence was 4% (95% CI 0.1 to 7,89) without significant differences (p>0.05). Conclusions: The prevalence of C. spp. was 4% without any demographic, environmental or clinics associations.

[Oocysts of the genus Cryptosporidium in domiciliated dogs from the city of Campos dos Goytacazes, the State of Rio de Janeiro]. / Oocistos do gênero Cryptosporidium em cães domiciliados na cidade de Campos dos Goytacazes, Estado do Rio de Janeiro.

This study had the objective of determining the occurrence of Cryptosporidium oocysts in domiciliated dogs from Campos dos Goytacazes City on Rio de Janeiro State. Feces samples were collected from 100 dogs, male and female, of different races, with age varying from 15 days to 15 years old and clinically healthy. These samples were analyzed by using the modified Ziehl-Neelsen technique. Among the dogs, 40% of them shed oocysts in their feces. In conclusion, there is a high number of asymptomatic domiciliated dogs in the City of Campos dos Goytacazes, that maintain the environmental contamination and provide infection for sensible animals.

Cryptosporidium spp. in traction horses in Santa Maria, RS, Brazil / Cryptosporidium spp. em equinos de tração de Santa Maria, RS

Investigou-se a ocorrência de Cryptosporidium spp. em equinos de tração, domiciliados na cidade de Santa Maria, RS. Foram coletadas amostras de fezes diretamente da ampola retal de 52 animais, machos e fêmeas, sem raça definida, na faixa etária do nascimento aos 20 anos de idade. Todos os animais estudados não apresentavam sinal clínico da parasitose. Dentre as amostras analisadas, 38,5 por cento (20/52)foram positivas para oocistos de Cryptosporidium spp. A ocorrência do parasito foi maior em animais jovens (75 por cento; 12/16). Conclui-se que há elevado número de animais assintomáticos eliminando oocistos, que contribuem com a contaminação ambiental e, sobretudo, submetem os carroceiros aos riscos da zoonose.

Cryptosporidium sp. y otros parásitos intestinales en niños menores de 5 años con diarrea y su relación con las pruebas coprocualitativas / Cryptosporidium sp. and other intestinal parasites in children under 5 years old with diarrhea and their relationship to coproquilitative tests

Para determinar la presencia de Cryptosporidium sp. y otros parásitos intestinales; así como su relación con las pruebas coprocualitativas, se analizaron 100 muestras fecales de niños de 3 meses a 5 años de edad, que asistieron al Laboratorio de Parasitología del Servicio Autónomo del Hospital Universitario de Maracaibo (SAHUM) con diagnóstico clínico de diarrea. Estas muestras fueron sometidas a un examen macroscópico y microscópico con SSF (0,85%) y lugol, coloración de Kinyoun para la detección de coccidios intestinales y las pruebas coprocualitativas: sangre oculta, azucares reductores y pH. Del total de muestras estudiadas, el 12% evidenció parásitos. Las especies encontradas fueron Cryptosporidium sp., Giardia lamblia y Blastocystis hominis con 4%cada uno, Trichuris trichiura (2%), Ascaris lumbricoides (1%), Pentatrichomonas hominis (1%). No se encontró correlación entre las pruebas coprocualitativas y las especies parasitarias identificadas, así como tampoco entre parasitosis y sexo. Cryptosporidium sp. y Giardia lamblia fueron los parásitos patógenos más frecuentes en niños < 2 años de edad

To determine the presence of Cryptosporidium sp. and other intestinal parasites, as well as their relation to coproqualitative tests, fecal samples were analyzed from 100 children ranging from 3 months to 5 years old, who attended the Autonomous Service Parasitology Laboratory at the University Hospital of Maracaibo (SAHUM) with a clinical diagnosis of diarrhea. These samples were subjected to macroscopic and microscopic examination with SSF (0.85%) and iodine, Kinyoun stain for the detection of intestinal coccidia, coproqualitative tests (occult blood, reducing sugars and pH). Of all the samples studied, 12% evidenced parasites. The species found were Cryptosporidium sp. (4%), Ascaris lumbricoides (1%), Trichuris trichiura (2%) Pentatrichomonas hominis (1%), Giardia lamblia and Blastocystis hominis at (4%). There was no correlation between the coproqualitative tests and the parasitic species identified, nor was there any relation ship between parasitosis and gender. Cryptosporidium sp. and Giardia lamblia were the most frequent pathogenic parasites in children < 2 years old

Infección por cryptosporidium sp y otros parásitos intestinales en manipulación de alimentos del estado Zulia Venezuela / Crytosporidium sp infections and other intestinales parasites in food handlers from Zulia state Venezuela

La criptosporidiosis en manipuladores de alimentos de Venezuela es desconocida. Con el propósito de determinar la prevalencia de Cryptosporidium y otros parásitos intestinales en manipuladores de alimentos del Estado Zulia, fueron evaluadas 119 muestras fecales mediante examen directo, método de concentración formol-éter y tinción permanente de Ziehl-Neelsen modificada. El 11,8% (14/119) de las muestras fueron positivas a Cryptosporidium. Todos los casos estaban asociados con otros protozoarios (p < 0,05), con mayor frecuencia Endolimax nana (42,9%). La prevalencia general de las parasitosis intestinales fue 48,7%, principalmente E. nana (41,2%), seguida por Blastocystis hominis (38,7%) y Entamoeba coli (17,6%). El monoparasitismo estuvo representado en el 37,9% (22/58) y el poliparasitismo en el 62,1% (36/58). El protozoario patógeno más frecuente fue Giardia lamblia (13,4%), seguido por el complejo Entamoeba histolytica/dispar (9,2%). El 4,1% de las muestras resultó positiva a helmintos con mayor frecuencia Ascaris lumbricoides (2,5%). La infección por Cryptosporidium sp y otros protozoarios es frecuente en los manipuladores de alimentos del Estado Zulia. Es necesario realizar estudios para determinar la relevancia clínica de esta parasitosis en manipuladores de alimentos y los consumidores de sus productos.

Cryptosporidiosis in food handlers from Venezuela is unknown, being this an important public health problem in immunosuppressed patients. To determine the prevalence of Cryptosporidium sp and other intestinal parasites in food handlers from Zulia State, one hundred nineteen fecal samples were evaluated by wet mount, concentrated according to Ritchie and modified Ziehl-Neelsen staining. Fourteen (11.8%) were positive for Cryptosporidium sp and associated with other protozoosis (P < 0.05), being most frequent Endolimax nana (42.9%). The general prevalence of the intestinal parasitism was 48.7%, emphasizing E. nana (41.2%), followed by Blastocystis hominis (38.7%) and Entamoeba coli (17.6%). The most frequent pathogenic protozoa was Giardia lamblia (13.4%), followed by the complex Entamoeba histolytica/E. dispar (9.2%). 4.1% were positive for intestinal helminthes. The infection by Cryptosporidium sp is frequent in food handlers from Zulia State. Given to the results of this investigation and the nonexistence of studies in this population, is necessary to deepen in the impact of this parasitism in food handlers and the consumers of their products.