Environmental and demographic risk factors associated with the prevalence of Cryptosporidium infection in the Alice rural settlements of the Eastern Cape Province of South Africa: a pilot s

Abstract

We undertook this study to identify the risk factors and prevalence of Cryptosporidium spp. in HIV-positive and HIV-negative diarrhea patients in the Alice rural settlement in the Eastern Cape Province of South Africa. A total of 180 stool specimens (35 HIV-positive diarrhea, 125 HIV-negative diarrhea patients, and 20 apparently healthy subjects) were screened for cryptosporidiosis using an ELISA-based approach. Sociodemographic information, water supply, and animal contact were recorded for diarrhea-positive patients. The data were analyzed using Pearson ’ s χ2 -test and Fisher ’ s exact test. Cryptosporidium antigen was detected in 122 of 180 specimens (overall prevalence = 67.8 % ). In HIV-positive diarrhea patients, the age groups 31 – 43 years (mean age 36.5 years) and 70 – 82 years (mean age 75.8 years) had a higher prevalence (100 % ) of the antigen than age groups 18 – 30 years (mean age 23.2 years) and 83 – 95 years (mean age 88.8 years) (50.0 % ). In HIV-negative diarrhea patients, the prevalence was highest (87.5 % ) at ages 18 – 30 years (mean age 23.2 years) and lowest (35.7 % ) at ages 83 – 95 years (mean age 88.8 years). Cryptosporidium antigenemia was slightly higher in females (78.2 % , mean age 46.7 years) than in males (71.1 % , mean age 42.6 years), but the difference was not significant (p > 0.05). No apparently healthy control subject was infected with Cryptosporidium . HIV-negative patients had a significantly higher prevalence of antigen than HIV-positive patients, with farm animals considered a possible risk factor