Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
Am J Trop Med Hyg. 2010 Nov;83(5):1110-5. doi: 10.4269/ajtmh.2010.09-0644.
Cryptosporidium is a leading cause of childhood diarrhea in developing countries. We investigated symptomatic and asymptomatic cryptosporidiosis in 20 children less than two years of age in a semi-urban slum in southern India. All surveillance (conducted every two weeks) and diarrheal samples from 20 children (n = 1,036) with cryptosporidial diarrhea previously identified by stool microscopy were tested by polymerase chain reaction-restriction fragment length polymorphism for species and subgenotype determination. Thirty-five episodes of cryptosporidiosis were identified in 20 children, of which 25 were diarrheal. Fifteen episodes were associated with prolonged oocyst shedding. Multiple episodes of cryptosporidiosis occurred in 40% of the children. Most infections were with C. hominis, subtype Ia. Children with multiple infections had significantly lower weight-for-age and height-for-age Z scores at 24 months but had scores comparable with children with a single episode by 36 months. Multiple symptomatic Cryptosporidium infections associated with prolonged oocyst shedding occur frequently in this disease-endemic area and may contribute to the long-term effects of cryptosporidiosis on physical growth in these children.
隐孢子虫是发展中国家儿童腹泻的主要原因。我们在印度南部一个半城市贫民窟中调查了 20 名两岁以下的有症状和无症状的隐孢子虫病患者。所有监测（每两周进行一次）和此前通过粪便显微镜检查发现患有隐孢子虫性腹泻的 20 名儿童（n=1036）的腹泻样本均通过聚合酶链反应-限制性片段长度多态性进行了检测，以确定物种和亚基因型。在 20 名儿童中发现了 35 次隐孢子虫病发作，其中 25 次是腹泻。15 次发作与卵囊持续排出有关。40%的儿童发生了多次隐孢子虫病。大多数感染是由人源隐孢子虫亚类 Ia 引起的。多次感染的儿童在 24 个月时体重和身高的 Z 分数明显较低，但到 36 个月时，这些分数与单次感染的儿童相当。在这个疾病流行地区，经常发生伴有卵囊持续排出的多次隐孢子虫感染，可能会对这些儿童的身体生长产生长期影响。
