Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville.
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Clin Infect Dis. 2018 Oct 15;67(9):1347-1355. doi: 10.1093/cid/ciy310.
Cryptosporidiosis is a major cause of childhood diarrhea in low- and middle-income countries and has been linked to impairment of child growth. This study investigated the burden of cryptosporidiosis and its impact on child growth in both a rural and an urban site in Bangladesh.
Pregnant women in the second trimester were identified at 2 sites in Bangladesh, 1 urban and 1 rural. Their offspring were enrolled at birth into the study (urban, n = 250; rural, n = 258). For 2 years, the children were actively monitored for diarrhea and anthropometric measurements were obtained every 3 months. Stool samples were collected monthly and during diarrheal episodes with Cryptosporidium infection and causative species determined by quantitative polymerase chain reaction assays.
Cryptosporidium infections were common at both sites and mostly subclinical. In the urban site, 161 (64%) children were infected and 65 (26%) had ≥2 infections. In the rural site, 114 (44%) were infected and 24 (9%) had multiple infections. Adjusted for potential confounders, cryptosporidiosis was associated with a significantly greater drop in the length-for-age z score (LAZ) at 24 months from LAZ at enrollment (Δ-LAZ), an effect greatest in the children with multiple episodes of cryptosporidiosis. The most common species in Mirpur was Cryptosporidium hominis, whereas Cryptosporidium meleagridis predominated in Mirzapur.
Cryptosporidiosis is common in early childhood and associated with early growth faltering in Bangladeshi children. Predominant Cryptosporidium species differed between the 2 sites, suggesting different exposures or modes of transmission but similar consequences for child growth.
NCT02764918.
隐孢子虫病是中低收入国家儿童腹泻的主要原因，与儿童生长受损有关。本研究调查了孟加拉国一个农村和一个城市地区隐孢子虫病的负担及其对儿童生长的影响。
在孟加拉国的 2 个地点（1 个城市和 1 个农村）确定了妊娠中期的孕妇。她们的子女在出生时即被纳入研究（城市，n=250；农村，n=258）。在 2 年内，对儿童进行积极的腹泻监测，并每 3 个月进行一次人体测量。每月采集粪便样本，并在出现腹泻时采集样本，通过定量聚合酶链反应检测隐孢子虫感染和病原体种类。
两个地点的隐孢子虫感染都很常见，且大多为无症状感染。在城市点，161 名（64%）儿童感染，65 名（26%）有≥2 次感染。在农村点，114 名（44%）感染，24 名（9%）有多次感染。调整潜在混杂因素后，隐孢子虫病与 24 个月时身长年龄 z 评分（LAZ）较入组时 LAZ 的显著下降（Δ-LAZ）显著相关，多次感染隐孢子虫病的儿童效应最大。Mirpur 最常见的种是人隐孢子虫，而 Mirzapur 则以微小隐孢子虫为主。
隐孢子虫病在儿童早期很常见，与孟加拉国儿童早期生长迟缓有关。两个地点的主要隐孢子虫种类不同，提示暴露或传播方式不同，但对儿童生长的影响相似。
NCT02764918。
