Molecular characterization of Cryptosporidium species and Giardia duodenalis from symptomatic Cambodian children

<strong>Background:</strong> In a prospective study, 498 single faecal samples from children aged under 16 years attending an outpatient clinic in the Angkor Hospital for Children, north west Cambodia, were examined for Cryptosporidium oocysts and Giardia cysts using microscopy and molec...

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Main Authors: Moore, C, Elwin, K, Phot, N, Seng, C, Mao, S, Suy, K, Kumar, V, Nader, J, Bousfield, R, Perera, S, Bailey, J, Beeching, N, Day, N, Parry, C, Chalmers, R
Format: Journal article
Published: Public Library of Science 2016
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author Moore, C
Elwin, K
Phot, N
Seng, C
Mao, S
Suy, K
Kumar, V
Nader, J
Bousfield, R
Perera, S
Bailey, J
Beeching, N
Day, N
Parry, C
Chalmers, R
author_facet Moore, C
Elwin, K
Phot, N
Seng, C
Mao, S
Suy, K
Kumar, V
Nader, J
Bousfield, R
Perera, S
Bailey, J
Beeching, N
Day, N
Parry, C
Chalmers, R
author_sort Moore, C
collection OXFORD
description <strong>Background:</strong> In a prospective study, 498 single faecal samples from children aged under 16 years attending an outpatient clinic in the Angkor Hospital for Children, north west Cambodia, were examined for Cryptosporidium oocysts and Giardia cysts using microscopy and molecular assays. <strong>Methodology/Principal Findings:</strong> Cryptosporidium oocysts were detected in 2.2% (11/498) of samples using microscopy and in 7.7% (38/498) with molecular tests. Giardia duodenalis cysts were detected in 18.9% (94/498) by microscopy and 27.7% (138/498) by molecular tests; 82% of the positive samples (by either method) were from children aged 1-10 years. Cryptosporidium hominis was the most common species of Cryptosporidium, detected in 13 (34.2%) samples, followed by Cryptosporidium meleagridis in 9 (23.7%), Cryptosporidium parvum in 8 (21.1%), Cryptosporidium canis in 5 (13.2%), and Cryptosporidium suis and Cryptosporidium ubiquitum in one sample each. Cryptosporidium hominis and C. parvum positive samples were subtyped by sequencing the GP60 gene: C. hominis IaA16R6 and C. parvum IIeA7G1 were the most abundant subtypes. Giardia duodenalis was typed using a multiplex real-time PCR targeting assemblages A and B. Assemblage B (106; 76.8% of all Giardia positive samples) was most common followed by A (12.3%) and mixed infections (5.1%). Risk factors associated with Cryptosporidium were malnutrition (AOR 9.63, 95% CI 1.67-55.46), chronic medical diagnoses (AOR 4.51, 95% CI 1.79-11.34) and the presence of birds in the household (AOR 2.99, 95% CI 1.16-7.73); specifically C. hominis (p=0.03) and C. meleagridis (p&lt;0.001) were associated with the presence of birds. The use of soap was protective against Giardia infection (OR 0.74, 95% CI 0.58-0.95). <strong>Conclusions/Significance:</strong> This is the first report to describe the different Cryptosporidium species and subtypes and Giardia duodenalis assemblages in Cambodian children. The variety of Cryptosporidium species detected indicates both anthroponotic and zoonotic transmission in this population. Interventions to improve sanitation, increase hand washing after defecation and before preparing food and promote drinking boiled water may reduce the burden of these two parasites.
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spelling oxford-uuid:db5c5f5c-6aa7-4e12-a910-1d2ec3624c492022-03-27T09:10:02ZMolecular characterization of Cryptosporidium species and Giardia duodenalis from symptomatic Cambodian childrenJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:db5c5f5c-6aa7-4e12-a910-1d2ec3624c49Symplectic Elements at OxfordPublic Library of Science2016Moore, CElwin, KPhot, NSeng, CMao, SSuy, KKumar, VNader, JBousfield, RPerera, SBailey, JBeeching, NDay, NParry, CChalmers, R<strong>Background:</strong> In a prospective study, 498 single faecal samples from children aged under 16 years attending an outpatient clinic in the Angkor Hospital for Children, north west Cambodia, were examined for Cryptosporidium oocysts and Giardia cysts using microscopy and molecular assays. <strong>Methodology/Principal Findings:</strong> Cryptosporidium oocysts were detected in 2.2% (11/498) of samples using microscopy and in 7.7% (38/498) with molecular tests. Giardia duodenalis cysts were detected in 18.9% (94/498) by microscopy and 27.7% (138/498) by molecular tests; 82% of the positive samples (by either method) were from children aged 1-10 years. Cryptosporidium hominis was the most common species of Cryptosporidium, detected in 13 (34.2%) samples, followed by Cryptosporidium meleagridis in 9 (23.7%), Cryptosporidium parvum in 8 (21.1%), Cryptosporidium canis in 5 (13.2%), and Cryptosporidium suis and Cryptosporidium ubiquitum in one sample each. Cryptosporidium hominis and C. parvum positive samples were subtyped by sequencing the GP60 gene: C. hominis IaA16R6 and C. parvum IIeA7G1 were the most abundant subtypes. Giardia duodenalis was typed using a multiplex real-time PCR targeting assemblages A and B. Assemblage B (106; 76.8% of all Giardia positive samples) was most common followed by A (12.3%) and mixed infections (5.1%). Risk factors associated with Cryptosporidium were malnutrition (AOR 9.63, 95% CI 1.67-55.46), chronic medical diagnoses (AOR 4.51, 95% CI 1.79-11.34) and the presence of birds in the household (AOR 2.99, 95% CI 1.16-7.73); specifically C. hominis (p=0.03) and C. meleagridis (p&lt;0.001) were associated with the presence of birds. The use of soap was protective against Giardia infection (OR 0.74, 95% CI 0.58-0.95). <strong>Conclusions/Significance:</strong> This is the first report to describe the different Cryptosporidium species and subtypes and Giardia duodenalis assemblages in Cambodian children. The variety of Cryptosporidium species detected indicates both anthroponotic and zoonotic transmission in this population. Interventions to improve sanitation, increase hand washing after defecation and before preparing food and promote drinking boiled water may reduce the burden of these two parasites.
spellingShingle Moore, C
Elwin, K
Phot, N
Seng, C
Mao, S
Suy, K
Kumar, V
Nader, J
Bousfield, R
Perera, S
Bailey, J
Beeching, N
Day, N
Parry, C
Chalmers, R
Molecular characterization of Cryptosporidium species and Giardia duodenalis from symptomatic Cambodian children
title Molecular characterization of Cryptosporidium species and Giardia duodenalis from symptomatic Cambodian children
title_full Molecular characterization of Cryptosporidium species and Giardia duodenalis from symptomatic Cambodian children
title_fullStr Molecular characterization of Cryptosporidium species and Giardia duodenalis from symptomatic Cambodian children
title_full_unstemmed Molecular characterization of Cryptosporidium species and Giardia duodenalis from symptomatic Cambodian children
title_short Molecular characterization of Cryptosporidium species and Giardia duodenalis from symptomatic Cambodian children
title_sort molecular characterization of cryptosporidium species and giardia duodenalis from symptomatic cambodian children
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