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Molecular characterization of Cryptosporidium spp. among children in rural Ghana.

Eibach D, Krumkamp R, Al-Emran HM, Sarpong N, Hagen RM, Adu-Sarkodie Y, Tannich E, May J - PLoS Negl Trop Dis (2015)

Bottom Line: C. hominis infection was mainly associated with diarrhoea (odds ratio [OR] = 2.4; 95% confidence interval [CI]: 1.2-4.9) whereas C. parvum infection was associated with both diarrhoea (OR = 2.6; CI: 1.2-5.8) and vomiting (OR = 3.1; 95% CI: 1.5-6.1).The infection mainly affects young infants, with vomiting and diarrhoea being one of the leading symptoms in C. parvum infection.Combining molecular typing and clinical data provides valuable information for physicians and is able to track sources of infections.

View Article: PubMed Central - PubMed

Affiliation: Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany; German Center for Infection Research (DZIF), partner site Hamburg-Borstel-Lübeck, Germany.

ABSTRACT

Background: The relevance of Cryptosporidium infections for the burden of childhood diarrhoea in endemic settings has been shown in recent years. This study describes Cryptosporidium subtypes among symptomatic and asymptomatic children in rural Ghana to analyse subtype-specific demographic, geographical, seasonal and clinical differences in order to inform appropriate control measures in endemic areas.

Methodology/principal findings: Stool samples were collected from 2232 children below 14 years of age presenting with and without gastrointestinal symptoms at the Agogo Presbyterian Hospital in the rural Ashanti region of Ghana between May 2007 and September 2008. Samples were screened for Cryptosporidium spp. by PCR and isolates were classified into subtypes based on sequence differences in the gp60 gene. Subtype specific frequencies for age, sex, location and season have been determined and associations with disease symptoms have been analysed within a case-control study. Cryptosporidium infections were diagnosed in 116 of 2232 (5.2%) stool samples. Subtyping of 88 isolates revealed IIcA5G3 (n = 26, 29.6%), IbA13G3 (n = 17, 19.3%) and IaA21R3 (n = 12, 13.6%) as the three most frequent subtypes of the two species C. hominis and C. parvum, known to be transmitted anthroponotically. Infections peak at early rainy season with 67.9% and 50.0% of infections during the months April, May and June for 2007 and 2008 respectively. C. hominis infection was mainly associated with diarrhoea (odds ratio [OR] = 2.4; 95% confidence interval [CI]: 1.2-4.9) whereas C. parvum infection was associated with both diarrhoea (OR = 2.6; CI: 1.2-5.8) and vomiting (OR = 3.1; 95% CI: 1.5-6.1).

Conclusions/significance: Cryptosporidiosis is characterized by seasonal anthroponotic transmission of strains typically found in Sub-Saharan Africa. The infection mainly affects young infants, with vomiting and diarrhoea being one of the leading symptoms in C. parvum infection. Combining molecular typing and clinical data provides valuable information for physicians and is able to track sources of infections.

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Phylogenetic analysis.Phylogenetic analysis of C. hominis and C. parvum subtypes and six reference strains with their respective accession numbers using neighbour-joining analysis of the gylcoprotein 60 (gp60) gene. Values on branches are percentage bootstrap values using 1,000 replicates. Only bootstrap values greater than 50% are shown.
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pntd.0003551.g003: Phylogenetic analysis.Phylogenetic analysis of C. hominis and C. parvum subtypes and six reference strains with their respective accession numbers using neighbour-joining analysis of the gylcoprotein 60 (gp60) gene. Values on branches are percentage bootstrap values using 1,000 replicates. Only bootstrap values greater than 50% are shown.

Mentions: For a subset of 88 (75.9%) out of the 116 Cryptosporidium patients/isolates the gp60 gene was successfully amplified. Alignments to reference strains classified 51 (58.0%) strains as C. hominis and 37 (42.1%) as C. parvum. Four different C. hominis subtype families (Ia, Ib, Id, Ie) and two C. parvum subtype families (IIc, IIe) were identified. Further sub-classification led to 16 different subtypes of which the three most frequently observed types were IIcA5G3a (n = 26, 29.6%), IbA13G3 (n = 17, 19.3%) and IaA21R3 (n = 12, 13.6%) (Table 1). Ia was the genetically most diverse subtype family, consisting of eight different subtypes, while the other C. hominis subtype families comprise only one single subtype (IbA13G3, IdA15, IeAA11G3T3). The subtype families IIc and IIe contained two subtypes each (IIcA5G3a, IIcA5G3b and IIeA10G1, IIeA10G2, respectively). This heterogeneity resulted in a discriminatory power of 0.848 for subtyping of the gp60 gene (Fig. 3).


Molecular characterization of Cryptosporidium spp. among children in rural Ghana.

Eibach D, Krumkamp R, Al-Emran HM, Sarpong N, Hagen RM, Adu-Sarkodie Y, Tannich E, May J - PLoS Negl Trop Dis (2015)

Phylogenetic analysis.Phylogenetic analysis of C. hominis and C. parvum subtypes and six reference strains with their respective accession numbers using neighbour-joining analysis of the gylcoprotein 60 (gp60) gene. Values on branches are percentage bootstrap values using 1,000 replicates. Only bootstrap values greater than 50% are shown.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4352007&req=5

pntd.0003551.g003: Phylogenetic analysis.Phylogenetic analysis of C. hominis and C. parvum subtypes and six reference strains with their respective accession numbers using neighbour-joining analysis of the gylcoprotein 60 (gp60) gene. Values on branches are percentage bootstrap values using 1,000 replicates. Only bootstrap values greater than 50% are shown.
Mentions: For a subset of 88 (75.9%) out of the 116 Cryptosporidium patients/isolates the gp60 gene was successfully amplified. Alignments to reference strains classified 51 (58.0%) strains as C. hominis and 37 (42.1%) as C. parvum. Four different C. hominis subtype families (Ia, Ib, Id, Ie) and two C. parvum subtype families (IIc, IIe) were identified. Further sub-classification led to 16 different subtypes of which the three most frequently observed types were IIcA5G3a (n = 26, 29.6%), IbA13G3 (n = 17, 19.3%) and IaA21R3 (n = 12, 13.6%) (Table 1). Ia was the genetically most diverse subtype family, consisting of eight different subtypes, while the other C. hominis subtype families comprise only one single subtype (IbA13G3, IdA15, IeAA11G3T3). The subtype families IIc and IIe contained two subtypes each (IIcA5G3a, IIcA5G3b and IIeA10G1, IIeA10G2, respectively). This heterogeneity resulted in a discriminatory power of 0.848 for subtyping of the gp60 gene (Fig. 3).

Bottom Line: C. hominis infection was mainly associated with diarrhoea (odds ratio [OR] = 2.4; 95% confidence interval [CI]: 1.2-4.9) whereas C. parvum infection was associated with both diarrhoea (OR = 2.6; CI: 1.2-5.8) and vomiting (OR = 3.1; 95% CI: 1.5-6.1).The infection mainly affects young infants, with vomiting and diarrhoea being one of the leading symptoms in C. parvum infection.Combining molecular typing and clinical data provides valuable information for physicians and is able to track sources of infections.

View Article: PubMed Central - PubMed

Affiliation: Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany; German Center for Infection Research (DZIF), partner site Hamburg-Borstel-Lübeck, Germany.

ABSTRACT

Background: The relevance of Cryptosporidium infections for the burden of childhood diarrhoea in endemic settings has been shown in recent years. This study describes Cryptosporidium subtypes among symptomatic and asymptomatic children in rural Ghana to analyse subtype-specific demographic, geographical, seasonal and clinical differences in order to inform appropriate control measures in endemic areas.

Methodology/principal findings: Stool samples were collected from 2232 children below 14 years of age presenting with and without gastrointestinal symptoms at the Agogo Presbyterian Hospital in the rural Ashanti region of Ghana between May 2007 and September 2008. Samples were screened for Cryptosporidium spp. by PCR and isolates were classified into subtypes based on sequence differences in the gp60 gene. Subtype specific frequencies for age, sex, location and season have been determined and associations with disease symptoms have been analysed within a case-control study. Cryptosporidium infections were diagnosed in 116 of 2232 (5.2%) stool samples. Subtyping of 88 isolates revealed IIcA5G3 (n = 26, 29.6%), IbA13G3 (n = 17, 19.3%) and IaA21R3 (n = 12, 13.6%) as the three most frequent subtypes of the two species C. hominis and C. parvum, known to be transmitted anthroponotically. Infections peak at early rainy season with 67.9% and 50.0% of infections during the months April, May and June for 2007 and 2008 respectively. C. hominis infection was mainly associated with diarrhoea (odds ratio [OR] = 2.4; 95% confidence interval [CI]: 1.2-4.9) whereas C. parvum infection was associated with both diarrhoea (OR = 2.6; CI: 1.2-5.8) and vomiting (OR = 3.1; 95% CI: 1.5-6.1).

Conclusions/significance: Cryptosporidiosis is characterized by seasonal anthroponotic transmission of strains typically found in Sub-Saharan Africa. The infection mainly affects young infants, with vomiting and diarrhoea being one of the leading symptoms in C. parvum infection. Combining molecular typing and clinical data provides valuable information for physicians and is able to track sources of infections.

Show MeSH
Related in: MedlinePlus