Abate Degu, Tschopp Rea, Seyoum Berhanu, Dessie Yadeta, Hasen Mahlet Osman, Gemechu Gizachew, Johansen Øystein Haarklau, Carmena David, Robertson Lucy J, Hanevik Kurt, Abdissa Alemseged
School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
PLoS Negl Trop Dis. 2025 Aug 5;19(8):e0013386. doi: 10.1371/journal.pntd.0013386. eCollection 2025 Aug.
Cryptosporidium infection causes diarrhea that may lead to malnutrition, growth faltering, cognitive impairment, and mortality if left untreated. Cryptosporidiosis continues to be a significant public health issue in low-income countries, including Ethiopia. However, its epidemiology among children under five years of age remains understudied. Therefore, this study aimed to determine the prevalence and factors associated with Cryptosporidium infection among diarrheic children under five in Eastern Ethiopia. A cross-sectional study was conducted among children under five years of age attending health centers with diarrhea in Eastern Ethiopia between November 2022 and October 2023. Fecal specimens were analyzed by auramine-phenol staining using light-emitting diode fluorescence microscopy. A structured questionnaire was used to obtain information on sociodemographic and other variables potentially associated with Cryptosporidium infection. Poisson regression with a robust variance model was employed to assess factors associated with Cryptosporidium infection using the prevalence ratio with 95% confidence intervals (CI).
This study included 756 diarrheic children under five years of age (mean = 20.8 months with a standard deviation of 13.4 and median of 16 months). The prevalence of Cryptosporidium infection was 15.2% (95% CI: 12.7-17.9). Wet season (adjusted prevalence ratio (APR) = 1.7, 95% CI: 1.2-2.4), having caregivers with no formal education (APR = 2.6, 95% CI: 1.1-6.3), presence of a diarrheic member in the household (APR = 1.9, 95% CI: 1.2-3.2), not being exclusively breastfed (APR = 1.6, 95% CI: 1.1-2.3), lack of handwashing practice after toileting (APR = 2.8, 95% CI: 1.7-4.5), and the use of toilet paper after defecation (APR = 1.6, 95% CI: 1.6-3.3) were factors significantly associated with increased risk of Cryptosporidium infection.
Cryptosporidiosis was highly prevalent in diarrheic children under five years of age in Eastern Ethiopia. Exclusive breastfeeding, improving sanitation, and ensuring proper hygiene practices are essential steps in reducing the risk of Cryptosporidium infection.
隐孢子虫感染会导致腹泻，如果不治疗，可能会导致营养不良、生长发育迟缓、认知障碍和死亡。隐孢子虫病在包括埃塞俄比亚在内的低收入国家仍然是一个重大的公共卫生问题。然而，其在五岁以下儿童中的流行病学情况仍未得到充分研究。因此，本研究旨在确定埃塞俄比亚东部五岁以下腹泻儿童中隐孢子虫感染的患病率及其相关因素。2022年11月至2023年10月期间，对埃塞俄比亚东部前往健康中心就诊的五岁以下腹泻儿童进行了一项横断面研究。粪便标本采用发光二极管荧光显微镜进行金胺酚染色分析。使用结构化问卷获取有关社会人口统计学和其他可能与隐孢子虫感染相关变量的信息。采用稳健方差模型的泊松回归，以患病率比及95%置信区间（CI）评估与隐孢子虫感染相关的因素。
本研究纳入了756名五岁以下腹泻儿童（平均年龄=20.8个月，标准差为13.4，中位数为16个月）。隐孢子虫感染的患病率为15.2%（95%CI：12.7-17.9）。雨季（调整患病率比（APR）=1.7，95%CI：1.2-2.4）、照料者未接受过正规教育（APR=2.6，95%CI：1.1-6.3）、家庭中有腹泻患者（APR=1.9，95%CI：1.2-3.2）、非纯母乳喂养（APR=1.6，95%CI：1.1-2.3）、便后缺乏洗手习惯（APR=2.8，95%CI：1.7-4.5）以及排便后使用卫生纸（APR=1.6，95%CI：1.6-3.3）是与隐孢子虫感染风险增加显著相关的因素。
隐孢子虫病在埃塞俄比亚东部五岁以下腹泻儿童中高度流行。纯母乳喂养、改善卫生条件和确保良好的卫生习惯是降低隐孢子虫感染风险的重要措施。
