Raccurt Christian P, Brasseur Philippe, Verdier Rose I, Li Xunde, Eyma Etna, Stockman Christine Pannier, Agnamey Patrice, Guyot Karine, Totet Anne, Liautaud Bernard, Nevez Gilles, Dei-Cas Eduardo, Pape Jean W
Service de Parasitologie et de Mycologie médicales, Faculté de Médecine et CHU d'Amiens, Université de Picardie Jules Verne, Amiens, France.
Trop Med Int Health. 2006 Jun;11(6):929-34. doi: 10.1111/j.1365-3156.2006.01631.x.
Contamination by water-born infectious diseases is closely linked to urban slums conditions such as overcrowding and high level of faecal pollution by animal and human excreta. In this environment, cryptosporidiosis is a major cause of acute diarrhoea in children and chronic persistent diarrhoea in AIDS patients, resulting in increased morbidity and mortality in both populations. The aims of this study conducted in Port-au-Prince, Haiti were to: (i) determine the frequency of Cryptosporidium infection in two populations of patients with diarrhoea, children and AIDS patients, and the existence of Cryptosporidium carriage in healthy adults living in close contact with them; (ii) identify by molecular genotyping the Cryptosporidium species involved; and (iii) evaluate the viability of Cryptosporidium oocysts isolated from human stools. From January 2000 to January 2001, 158 of 1529 diarrhoea stool samples collected from 93 patients with diarrhoea, 57 adults followed at Centres GHESKIO and 36 children admitted at the University Hospital in Port-au-Prince contained Cryptosporidium oocysts (10.3%). The majority of adult patients (98%) were HIV-infected whereas the majority of children (81%) tested negative for HIV. Cryptosporidium was documented in only 1/102 healthy persons living in contact with Cryptosporidium infected patients and infection was with the same genotype as that of the contact patient. Among the 69 Cryptosporidium isolates studied for genotyping, three species were identified: C. hominis (59%), C. parvum (38%) and C. felis (3%). The two C. felis cases are the first reported from AIDS patients in the Caribbean. Most of the children regardless of their HIV status were infected with C. hominis (72%), whereas AIDS patients were more likely to be infected by either human or animal genotypes. These data confirm that immunocompromised individuals are susceptible to a wide range of Cryptosporidium spp. Viability of Cryptosporidium oocysts were determined in an experimental mouse model for 17/18 specimen studied including in 12/13 C. hominis, 4/4 C. parvum and 1/1 C. felis. Infectivity in newborn mice was found to be dose-dependent and more effective with C. parvum than the other two genotypes. Cryptosporidiosis remains a frequent hazard for both AIDS patients and young children in Haiti because of poor hygiene, particularly contaminated water and overcrowded conditions associated with urban slums.
水源性传染病的污染与城市贫民窟的状况密切相关，如过度拥挤以及动物和人类排泄物造成的高水平粪便污染。在这种环境下，隐孢子虫病是儿童急性腹泻和艾滋病患者慢性持续性腹泻的主要病因，导致这两类人群的发病率和死亡率上升。在海地太子港进行的这项研究的目的是：（i）确定腹泻患者（儿童和艾滋病患者）两类人群中隐孢子虫感染的频率，以及与他们密切接触的健康成年人中隐孢子虫携带情况；（ii）通过分子基因分型鉴定所涉及的隐孢子虫种类；（iii）评估从人类粪便中分离出的隐孢子虫卵囊的活力。从2000年1月至2001年1月，从93例腹泻患者（在GHESKIO中心随访的57名成年人和太子港大学医院收治的36名儿童）收集的1529份腹泻粪便样本中，有158份含有隐孢子虫卵囊（10.3%）。大多数成年患者（98%）感染了艾滋病毒，而大多数儿童（81%）艾滋病毒检测呈阴性。在与隐孢子虫感染患者接触的102名健康人中，仅1人检测到隐孢子虫，且感染基因型与接触患者相同。在研究基因分型的69株隐孢子虫分离株中，鉴定出三种：人隐孢子虫（59%）、微小隐孢子虫（38%）和猫隐孢子虫（3%）。两例猫隐孢子虫病例是加勒比地区首次报道的艾滋病患者感染病例。大多数儿童，无论其艾滋病毒感染状况如何，感染的是人隐孢子虫（72%），而艾滋病患者更易感染人源或动物源基因型。这些数据证实免疫功能低下个体易感染多种隐孢子虫。在所研究的18份样本中的17份（包括13份人隐孢子虫中的12份、4份微小隐孢子虫中的4份和1份猫隐孢子虫中的1份），在实验小鼠模型中测定了隐孢子虫卵囊的活力。发现新生小鼠的感染性呈剂量依赖性，微小隐孢子虫比其他两种基因型更具感染性。由于卫生条件差，特别是受污染的水以及与城市贫民窟相关的过度拥挤状况，隐孢子虫病在海地仍然是艾滋病患者和幼儿的常见危害。
