Bauhofer Adilson Fernando Loforte, Cossa-Moiane Idalécia Laurinda Carlos, Marques Selma Domingos Amadeu, Guimarães Esperança Lourenço Alberto Mabandane, Munlela Benilde António, Anapakala Elda Muianga, Chiláule Jorfélia José, Cassocera Marta, Langa Jerónimo Souzinho, Chissaque Assucênio, Sambo Júlia Assiat Monteiro, Manhique-Coutinho Lena Vânia, Bero Diocreciano Matias, Kellogg Timothy Allen, Gonçalves Luzia Augusta Pires, de Deus Nilsa
Instituto Nacional de Saúde (INS), Maputo, Mozambique.
Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.
BMC Infect Dis. 2021 Feb 23;21(1):201. doi: 10.1186/s12879-021-05881-7.
In Mozambique, infection by intestinal parasites is reported all over the country. However, infection in children with diarrhoea is mostly focused in the southern region of Mozambique. This work aims to determine the frequency and potential risk factors for infection by Cryptosporidium spp., Giardia lamblia, and Entamoeba histolytica in children under-five years hospitalized with diarrhoea in Hospital Central de Nampula, northern Mozambique.
A cross-sectional hospital-based surveillance was conducted between March 2015 and January 2018 in children admitted with diarrhoea in Hospital Central de Nampula. Sociodemographic information was obtained through semi-structured interviews applied to the children's caregivers. A single stool sample was collected from each child to detect antigens from Cryptosporidium spp., G. lamblia, and E. histolytica using an immune-enzymatic technique. Crude and adjusted odds ratios (with 95% Confidence Intervals) were obtained by logistic regression models to identify factors associated with infection by Cryptosporidium spp. and G. lamblia.
The median age and interquartile intervals of our sample population was 12 months (8-20). Intestinal protozoa were detected in 21.4% (59/276). Cryptosporidium spp. was the most common protozoa (13.9% - 38/274), followed by G. lamblia (9.1% - 25/274) and E. histolytica (0.4% - 1/275). Children with illiterate caregiver's (p-value = 0.042) and undernourished (p-value = 0.011) were more likely to be infected by Cryptosporidium spp. G. lamblia was more common in children living in households with more than four members (p-value = 0.039). E. histolytica was detected in an eleven month's child, co-infected with Cryptosporidium spp. and undernourished.
Cryptosporidium spp. and Giardia lamblia were the most common pathogenic intestinal protozoa detected in children with diarrhoea hospitalized in the Hospital Central de Nampula. Our findings obtained highlight the importance of exploring the caregiver's education level, children's nutritional status for infections with Cryptosporidium spp., and living conditions, namely crowded households for infections with G. lamblia in children younger than five years.
在莫桑比克，全国范围内均有肠道寄生虫感染的报告。然而，腹泻儿童的感染情况大多集中在莫桑比克南部地区。本研究旨在确定莫桑比克北部楠普拉中央医院五岁以下腹泻住院儿童感染隐孢子虫属、蓝氏贾第鞭毛虫和溶组织内阿米巴的频率及潜在风险因素。
2015年3月至2018年1月期间，对楠普拉中央医院腹泻住院儿童进行了一项基于医院的横断面监测。通过对儿童看护者进行半结构化访谈获取社会人口学信息。从每个儿童收集一份粪便样本，采用免疫酶技术检测隐孢子虫属、蓝氏贾第鞭毛虫和溶组织内阿米巴的抗原。通过逻辑回归模型获得粗比值比和调整比值比（95%置信区间），以确定与隐孢子虫属和蓝氏贾第鞭毛虫感染相关的因素。
我们样本人群的年龄中位数和四分位间距为12个月（8 - 20个月）。在21.4%（59/276）的儿童中检测到肠道原生动物。隐孢子虫属是最常见的原生动物（13.9% - 38/274），其次是蓝氏贾第鞭毛虫（9.1% - 25/274）和溶组织内阿米巴（0.4% - 1/275）。看护者为文盲的儿童（p值 = 0.042）和营养不良的儿童（p值 = 0.011）感染隐孢子虫属的可能性更高。蓝氏贾第鞭毛虫在家庭成员超过四人家庭中的儿童中更为常见（p值 = 0.039）。在一名11个月大的儿童中检测到溶组织内阿米巴，该儿童同时感染了隐孢子虫属且营养不良。
隐孢子虫属和蓝氏贾第鞭毛虫是楠普拉中央医院腹泻住院儿童中检测到的最常见致病性肠道原生动物。我们的研究结果凸显了探究看护者教育水平、儿童营养状况对隐孢子虫属感染的重要性，以及居住条件，即拥挤家庭对五岁以下儿童蓝氏贾第鞭毛虫感染的重要性。
