Respiratory cryptosporidiosis in Malawian children with diarrheal disease.

<h4>Background</h4>Respiratory cryptosporidiosis has been documented in children with diarrhea. We sought to describe the dynamics of respiratory involvement in children hospitalized with gastrointestinal (GI) diarrheal disease.<h4>Methods</h4>We conducted a prospective, obse...

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Autores principales:	Pui-Ying Iroh Tam, Mphatso Chisala, Wongani Nyangulu, Herbert Thole, James Nyirenda
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/ed75b0027c3c4302ac0cb4eb9b2d2370
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spelling	oai:doaj.org-article:ed75b0027c3c4302ac0cb4eb9b2d23702021-11-25T06:33:26ZRespiratory cryptosporidiosis in Malawian children with diarrheal disease.1935-27271935-273510.1371/journal.pntd.0009643https://doaj.org/article/ed75b0027c3c4302ac0cb4eb9b2d23702021-07-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009643https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Respiratory cryptosporidiosis has been documented in children with diarrhea. We sought to describe the dynamics of respiratory involvement in children hospitalized with gastrointestinal (GI) diarrheal disease.<h4>Methods</h4>We conducted a prospective, observational longitudinal study of Malawian children 2-24 months hospitalized with diarrhea. Nasopharyngeal (NP) swabs, induced sputum and stool specimens were collected. Participants that were positive by Cryptosporidium PCR in any of the three compartments were followed up with fortnightly visits up to 8 weeks post-enrollment.<h4>Results</h4>Of the 162 children recruited, participants had mild-moderate malnutrition (mean HAZ -1.6 (SD 2.1)), 37 (21%) were PCR-positive for Cryptosporidium at enrollment (37 stool, 11 sputum, and 4 NP) and 27 completed the majority of follow-up visits (73%). Cryptosporidium was detected in all compartments over the 4 post-enrollment visits, most commonly in stool (100% at enrollment with mean cycle thresholds (Ct) of 28.8±4.3 to 44% at 8 weeks with Ct 29.9±4.1), followed by sputum (31% at enrollment with mean Ct 31.1±4.4 to 20% at 8 weeks with Ct 35.7±2.6), then NP (11% with mean Ct 33.5±1.0 to 8% with Ct 36.6±0.7). Participants with Cryptosporidium detection in both the respiratory and GI tract over the study period reported respiratory and GI symptoms in 81% and 62% of study visits, respectively, compared to 68% and 27%, respectively, for those with only GI detection, and had longer GI shedding (17.5±6.6 v. 15.9±2.9 days).<h4>Conclusion</h4>Cryptosporidium was detected in both respiratory and GI tracts throughout the 8 weeks post-enrollment. The development of therapeutics for Cryptosporidium in children should target the respiratory as well as GI tract.Pui-Ying Iroh TamMphatso ChisalaWongani NyanguluHerbert TholeJames NyirendaPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 7, p e0009643 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Pui-Ying Iroh Tam Mphatso Chisala Wongani Nyangulu Herbert Thole James Nyirenda Respiratory cryptosporidiosis in Malawian children with diarrheal disease.
description	<h4>Background</h4>Respiratory cryptosporidiosis has been documented in children with diarrhea. We sought to describe the dynamics of respiratory involvement in children hospitalized with gastrointestinal (GI) diarrheal disease.<h4>Methods</h4>We conducted a prospective, observational longitudinal study of Malawian children 2-24 months hospitalized with diarrhea. Nasopharyngeal (NP) swabs, induced sputum and stool specimens were collected. Participants that were positive by Cryptosporidium PCR in any of the three compartments were followed up with fortnightly visits up to 8 weeks post-enrollment.<h4>Results</h4>Of the 162 children recruited, participants had mild-moderate malnutrition (mean HAZ -1.6 (SD 2.1)), 37 (21%) were PCR-positive for Cryptosporidium at enrollment (37 stool, 11 sputum, and 4 NP) and 27 completed the majority of follow-up visits (73%). Cryptosporidium was detected in all compartments over the 4 post-enrollment visits, most commonly in stool (100% at enrollment with mean cycle thresholds (Ct) of 28.8±4.3 to 44% at 8 weeks with Ct 29.9±4.1), followed by sputum (31% at enrollment with mean Ct 31.1±4.4 to 20% at 8 weeks with Ct 35.7±2.6), then NP (11% with mean Ct 33.5±1.0 to 8% with Ct 36.6±0.7). Participants with Cryptosporidium detection in both the respiratory and GI tract over the study period reported respiratory and GI symptoms in 81% and 62% of study visits, respectively, compared to 68% and 27%, respectively, for those with only GI detection, and had longer GI shedding (17.5±6.6 v. 15.9±2.9 days).<h4>Conclusion</h4>Cryptosporidium was detected in both respiratory and GI tracts throughout the 8 weeks post-enrollment. The development of therapeutics for Cryptosporidium in children should target the respiratory as well as GI tract.
format	article
author	Pui-Ying Iroh Tam Mphatso Chisala Wongani Nyangulu Herbert Thole James Nyirenda
author_facet	Pui-Ying Iroh Tam Mphatso Chisala Wongani Nyangulu Herbert Thole James Nyirenda
author_sort	Pui-Ying Iroh Tam
title	Respiratory cryptosporidiosis in Malawian children with diarrheal disease.
title_short	Respiratory cryptosporidiosis in Malawian children with diarrheal disease.
title_full	Respiratory cryptosporidiosis in Malawian children with diarrheal disease.
title_fullStr	Respiratory cryptosporidiosis in Malawian children with diarrheal disease.
title_full_unstemmed	Respiratory cryptosporidiosis in Malawian children with diarrheal disease.
title_sort	respiratory cryptosporidiosis in malawian children with diarrheal disease.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ed75b0027c3c4302ac0cb4eb9b2d2370
work_keys_str_mv	AT puiyingirohtam respiratorycryptosporidiosisinmalawianchildrenwithdiarrhealdisease AT mphatsochisala respiratorycryptosporidiosisinmalawianchildrenwithdiarrhealdisease AT wonganinyangulu respiratorycryptosporidiosisinmalawianchildrenwithdiarrhealdisease AT herbertthole respiratorycryptosporidiosisinmalawianchildrenwithdiarrhealdisease AT jamesnyirenda respiratorycryptosporidiosisinmalawianchildrenwithdiarrhealdisease
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Respiratory cryptosporidiosis in Malawian children with diarrheal disease.

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