Javier Enriquez F, Avila C R, Ignacio Santos J, Tanaka-Kido J, Vallejo O, Sterling C R
Department of Veterinary Science, University of Arizona, Tucson, USA.
Am J Trop Med Hyg. 1997 Mar;56(3):254-7. doi: 10.4269/ajtmh.1997.56.254.
Using an indirect immunofluorescence assay on stool samples, we found a 6.4% prevalence of cryptosporidiosis among 403 children less than five years of age with acute diarrhea in Mexico City over a one-year period. The prevalence was highest (11.4%) during the rainy summer months. Most Cryptosporidium parvum cases occurred in infants less than one year of age. Cryptosporidium parvum was more common in malnourished children (P < 0.05) and in nonbreast-fed infants less than six months of age (P < 0.01). Neither dwelling characteristics nor the presence of domestic animals at home were associated with C. parvum infection. Enteropathogenic bacteria were found in 26.8% of the children; Escherichia coli, Salmonella, and Shigella being the most frequently identified. None of 100 serum samples tested showed antibodies against human immunodeficiency virus. When compared with immunofluorescence, the acid-fast technique showed a sensitivity of 76.9% and a specificity of 98.9%, with a predictive positive value of 83.3%. It was concluded that 1) monoclonal antibody-based immunofluorescence is a better diagnostic tool than the acid-fast technique, 2) the prevalence of cryptosporidiosis in this population was similar to that of other developing countries, 3) clinical manifestations were nonspecific, and 4) C. parvum was more common in malnourished children and in nonbreast-fed infants.
通过对粪便样本进行间接免疫荧光检测，我们发现在墨西哥城1年期间403名5岁以下急性腹泻儿童中，隐孢子虫病患病率为6.4%。在夏季多雨月份患病率最高（11.4%）。大多数微小隐孢子虫病例发生在1岁以下婴儿中。微小隐孢子虫在营养不良儿童中更常见（P<0.05），在6个月以下非母乳喂养婴儿中更常见（P<0.01）。居住特征和家中是否饲养家畜均与微小隐孢子虫感染无关。26.8%的儿童检测到肠道致病菌；最常检测到的是大肠杆菌、沙门氏菌和志贺氏菌。100份血清样本检测均未显示抗人类免疫缺陷病毒抗体。与免疫荧光法相比，抗酸染色技术的敏感性为76.9%，特异性为98.9%，阳性预测值为83.3%。得出以下结论：1）基于单克隆抗体的免疫荧光法是比抗酸染色技术更好的诊断工具；2）该人群中隐孢子虫病患病率与其他发展中国家相似；3）临床表现无特异性；4）微小隐孢子虫在营养不良儿童和非母乳喂养婴儿中更常见。
