Cryptosporidium Sp. Findings and Its Symptomatology among Immunocompromised Patients

Authors

  • Dewi Masyithah Darlan Department of Parasitology, Faculty of Medicine, Universitas Sumatera Utara, Padang Bulan, Medan Baru, Medan, Sumatera Utara, Indonesia
  • Muhammad Fakhrur Rozi Faculty of Medicine, Universitas Sumatera Utara, Padang Bulan, Medan Baru, Medan, Sumatera Utara, Indonesia
  • Yunilda Andriyani Department of Parasitology, Faculty of Medicine, Universitas Sumatera Utara, Padang Bulan, Medan Baru, Medan, Sumatera Utara, Indonesia
  • Hemma Yulfi Department of Parasitology, Faculty of Medicine, Universitas Sumatera Utara, Padang Bulan, Medan Baru, Medan, Sumatera Utara, Indonesia
  • Restuti Hidayani Saragih Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Padang Bulan, Medan, Sumatera Utara, Indonesia
  • Nerdy Nerdy Department of Pharmaceutical Chemistry, Academy of Pharmacy Yayasan Tenaga Pembangunan Arjuna, Pintubosi, Laguboti, Toba Samosir, Sumatera Utara, Indonesia, 22381 http://orcid.org/0000-0002-1993-4415

DOI:

https://doi.org/10.3889/oamjms.2019.329

Keywords:

Cryptosporidium sp., Diarrhea, Protozoa

Abstract

BACKGROUND: Cryptosporidium sp. is an apicomplexan protozoa, and it is related to an immunocompromised state. As it develops diverse clinical manifestations, mild to life-threatening conditions, administration of anti-parasitic medication and its management remain problematic.

AIM: The study aimed to provide Cryptosporidiosis symptomatology and its prevalence among HIV-infected patients in a tertiary referral hospital, Haji Adam Malik General Hospital, Medan, Indonesia.

MATERIAL AND METHODS: Symptomatology was noted using short-questionnaire, and laboratory findings were obtained from the hospital medical record registry on the same day of admission. We enrolled 24 patients were suffered from HIV infection for a certain period and more than one-week diarrhoea including 18 males and 6 females. Routine faeces examination using wet mount, Kinyoun-gabet, and trichrome staining was performed for all samples in Parasitology Department, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. Numerical data were evaluated using the Mann-Whitney test while Fisher Exact test was used to determine any association between categorical variables.

RESULTS: Our study found that 8 of 24 patients were positive with Cryptosporidium sp. while its symptomatology including abdominal cramp (66.7%), nausea and vomiting (70.8%), and fever (62.5%) is prevalent from our study. We obtained significant association between CD4 cell count (p = 0.006), diarrhea duration (p = 0.007), abdominal pain (p = 0.005), and nausea and vomiting (p = 0.021) with cryptosporidiosis.

CONCLUSION: High consideration of several symptoms related to cryptosporidiosis leads a clinician to initiate prompt management particularly in a high-risk population.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

Author Biography

Nerdy Nerdy, Department of Pharmaceutical Chemistry, Academy of Pharmacy Yayasan Tenaga Pembangunan Arjuna, Pintubosi, Laguboti, Toba Samosir, Sumatera Utara, Indonesia, 22381

Department of Pharmaceutical Chemistry, Academy of Pharmacy Yayasan Tenaga Pembangunan Arjuna, Pintubosi, Laguboti, Toba Samosir, Sumatera Utara, Indonesia, 22381

https://www.scopus.com/authid/detail.uri?authorId=56366211400

http://orcid.org/0000-0002-1993-4415

https://scholar.google.co.id/citations?user=sCn68VYAAAAJ&hl=en

http://sinta2.ristekdikti.go.id/authors/detail?id=6158627&view=overview

References

Bouzid M, Hunter PR, Chalmers RM, Tyler KM. Cryptosporidium pathogenicity and virulence. Clin Microbiol Rev. 2013; 26(1):115-34. https://doi.org/10.1128/CMR.00076-12 PMid:23297262 PMCid:PMC3553671

Certad G, Viscogliosi E, Chabé M, Cacciò SM. Pathogenic mechanisms of Cryptosporidium and Giardia. Trend Parasitol. 2017; 33(7):561-76. https://doi.org/10.1016/j.pt.2017.02.006 PMid:28336217

Tas Cengiz Z, Yilmaz H, Halil Sahin I, Kapmaz M. The Frequency of Cryptosporidium spp. in Immunocompromised Patients by Modified Acid-Fast Staining, Cassette Kit and ELISA Methods: Comparison of the Diagnostic Techniques. Jund J Microbiol. 2016; 10(2):1-5. https://doi.org/10.5812/jjm.36479

Iqbal A, Lim AI, Al Mahdy M, Dixon B, Surin J. Epidemiology of cryptosporidiosis in HIV-infected individuals-a global perspective. J AIDS Clin Reports. 2012; 1(9):1-6.

Tumwine JK, Kekitiinwa A, Bakeera-Kitaka S, Ndeezi G, Downing R, Feng X, Akiyoshi DE, Tzipori S. Cryptosporidiosis and microsporidiosis in Ugandan children with persistent diarrhea with and without concurrent infection with the human immunodeficiency virus. Am J Trop Med Hyg. 2005; 73(5):921-5. https://doi.org/10.4269/ajtmh.2005.73.921 PMid:16282304

Prasetyo R. Intestinal parasites infection in AIDS patients with chronic diarrhea at Dr. Soetomo General Hospital Surabaya. Ind J Trop Infect Dis. 2010; 1(1):36-7. https://doi.org/10.20473/ijtid.v1i1.3721

Kurniawan A, Karyadi T, Dwintasari SW, Sari IP, Yunihastuti E, Djauzi S, Smith HV. Intestinal parasitic infections in HIV/AIDS patients presenting with diarrhoea in Jakarta, Indonesia. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009; 103(9):892-8. https://doi.org/10.1016/j.trstmh.2009.02.017 PMid:19327806

Chalmers RM, Katzer F. Looking for Cryptosporidium: the application of advances in detection and diagnosis. Trends Parasitol. 2013; 29(5):237-51. https://doi.org/10.1016/j.pt.2013.03.001 PMid:23566713

Mohaghegh MA, Hejazi SH, Ghomashlooyan M, Kalani H, Mirzaei F, Azami M. Prevalence and clinical features of Cryptosporidium infection in hemodialysis patients. Gastroenterol Hepatol bed to bench. 2017; 10(2):137.

Ajjampur SR, Asirvatham JR, Muthusamy D, Gladstone BP, Abraham OC, Mathai D, Ward H, Wanke C, Kang G. Clinical features & risk factors associated with cryptosporidiosis in HIV infected adults in India. Ind J Med Res. 2007; 126(6):553.

Abubakar I, Aliyu SH, Arumugam C, Usman NK, Hunter PR. Treatment of cryptosporidiosis in immunocompromised individuals: systematic review and metaâ€analysis. Brit J Clin Pharm. 2007; 63(4):387-93. https://doi.org/10.1111/j.1365-2125.2007.02873.x PMid:17335543 PMCid:PMC2203234

Savioli L, Smith H, Thompson A. Giardia and Cryptosporidium join the 'neglected diseases initiative'. Trends Parasitol. 2006; 22(5):203-8. https://doi.org/10.1016/j.pt.2006.02.015 PMid:16545611

Chappell CL, Okhuysen PC, Langer-Curry R, Widmer G, Akiyoshi DE, Tanriverdi S, Tzipori S. Cryptosporidium hominis: experimental challenge of healthy adults. Am J Trop Med Hyg. 2006; 75(5):851-7. https://doi.org/10.4269/ajtmh.2006.75.851 PMid:17123976

Ballani N, Shujatullah F, Khan HM, Malik A, Ali MS, Khan PA. Intestinal protozoa in immunosuppression: a medical hassle. J Bacteriol Parasitol. 2012; 3(138):2. https://doi.org/10.4172/2155-9597.1000138

Sadek GS, Bahaa El Deen W. Role of COX-2 in Pathogenesis of Intestinal Cryptosporidiosis and Effect of some Drugs on Treatment of Infection. Res J Parasitol. 2014; 9(2):21-40. https://doi.org/10.3923/jp.2014.21.40

Leitch GJ, He Q. Cryptosporidiosis-an overview. J Biomed Res. 2012; 25(1):1-6. https://doi.org/10.1016/S1674-8301(11)60001-8

Stark D, Barratt JL, Van Hal S, Marriott D, Harkness J, Ellis JT. Clinical significance of enteric protozoa in the immunosuppressed human population. Clin Micro Rev. 2009; 22(4):634-50. https://doi.org/10.1128/CMR.00017-09 PMid:19822892 PMCid:PMC2772358

Zhang Q, Frange P, Blanche S, Casanova JL. Pathogenesis of infections in HIV-infected individuals: insights from primary immunodeficiencies. Curr opinion immunol. 2017; 48:122-33. https://doi.org/10.1016/j.coi.2017.09.002 PMid:28992464 PMCid:PMC5682227

Rossle NF, Latif B. Cryptosporidiosis as threatening health problem: a review. Asian Pacific J Trop Biomed. 2013; 3(11):916-24. https://doi.org/10.1016/S2221-1691(13)60179-3

Beatty GW. Diarrhea in patients infected with HIV presenting to the emergency department. Emergency Med Clin. 2010; 28(2):299-310. https://doi.org/10.1016/j.emc.2010.01.003 PMid:20413013

Tzipori S, Ward H. Cryptosporidiosis: biology, pathogenesis and disease. Micro Inf. 2002; 4(10):1047-58. https://doi.org/10.1016/S1286-4579(02)01629-5

Wanyiri JW, Kanyi H, Maina S, Wang DE, Steen A, Ngugi P, Kamau T, Waithera T, O'Connor R, Gachuhi K, Wamae CN. Cryptosporidiosis in HIV/AIDS patients in Kenya: clinical features, epidemiology, molecular characterization and antibody responses. Am J Trop Med Hyg. 2014; 91(2):319-28. https://doi.org/10.4269/ajtmh.13-0254 PMid:24865675 PMCid:PMC4125256

Izadi M, Jonaidiâ€Jafari N, Saburi A, Eyni H, Rezaiemanesh MR, Ranjbar R. Prevalence, molecular characteristics and risk factors for cryptosporidiosis among Iranian immunocompromised patients. Microbiol Immunol. 2012; 56(12):836-42. https://doi.org/10.1111/j.1348-0421.2012.00513.x PMid:23088420

O'connor RM, Shaffie R, Kang G, Ward HD. Cryptosporidiosis in patients with HIV/AIDS. AIDS. 2011; 25(5):549-60. https://doi.org/10.1097/QAD.0b013e3283437e88 PMid:21160413

Cama VA, Ross JM, Crawford S, Kawai V, Chavez-Valdez R, Vargas D, Vivar A, Ticona E, Navincopa M, Williamson J, Ortega Y. Differences in clinical manifestations among Cryptosporidium species and subtypes in HIV-infected persons. J Infect Dis. 2007; 196(5):684-91. https://doi.org/10.1086/519842 PMid:17674309

Sparks H, Nair G, Castellanos-Gonzalez A, White AC. Treatment of Cryptosporidium: what we know, gaps, and the way forward. Curr Trop Med Reports. 2015; 2(3):181-7. https://doi.org/10.1007/s40475-015-0056-9 PMid:26568906 PMCid:PMC4640180

Cabada MM, White Jr AC. Treatment of cryptosporidiosis: do we know what we think we know? Curr Opinion Infect Dis. 2010; 23(5):494-9. https://doi.org/10.1097/QCO.0b013e32833de052 PMid:20689422

Published

2019-05-14

How to Cite

1.
Darlan DM, Rozi MF, Andriyani Y, Yulfi H, Saragih RH, Nerdy N. Cryptosporidium Sp. Findings and Its Symptomatology among Immunocompromised Patients. Open Access Maced J Med Sci [Internet]. 2019 May 14 [cited 2024 Apr. 23];7(10):1567-71. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2019.329

Issue

Section

A - Basic Science

Most read articles by the same author(s)

1 2 > >>