Abstract

Background

Cryptosporidium is a leading cause of diarrhea in Sub-Saharan Africa and is associated with substantial morbidity and mortality in young children.

Methods

We analyzed data from children aged 6–71 months presenting to 2 public hospitals in Western Kenya with acute diarrhea and their primary caregivers, including detection of Cryptosporidium by quantitative polymerase chain reaction (PCR) and immunoassay analysis in stool samples from both children and their caregivers. Associations between potential transmission sources and child/caregiver Cryptosporidium infection were evaluated using prevalence ratios (PRs). Secondary analyses evaluated host and clinical risk factors of child/caregiver Cryptosporidium infection.

Results

Among 243 child–caregiver pairs enrolled, 77 children (32%) and 57 caregivers (23%) had Cryptosporidium identified by either immunoassay or PCR. Twenty-six of the 243 child–caregiver pairs (11%) had concordant detection of Cryptosporidium. Cryptosporidium infection in children was associated with detection of Cryptosporidium in caregivers (adjusted PR [aPR], 1.8; 95% CI, 1.2 to 2.6; P = .002) and unprotected water source (aPR, 2.0; 95% CI, 1.3 to 3.2; P = .003). Risk factors for Cryptosporidium detection in caregivers included child Cryptosporidium infection (aPR, 2.0; 95% CI, 1.3 to 3.0; P = .002) as well as cow (aPR, 3.1; 95% CI, 1.4 to 7.0; P = .02) and other livestock ownership (aPR, 2.6; 95% CI, 1.1 to 6.3; P = .03) vs no livestock ownership. Recent diarrhea in caregivers and children was independently associated with child and caregiver Cryptosporidium infections, respectively.

Conclusions

Our results are consistent with the hypothesis that Cryptosporidium transmission can occur directly between child–caregiver dyads as well as through other pathways involving water and livestock. Additional research into caregivers as a source of childhood Cryptosporidium infection is warranted.

Details

Title
Prevalence and Correlates of Cryptosporidium Infections in Kenyan Children With Diarrhea and Their Primary Caregivers
Author
Deichsel, Emily L 1   VIAFID ORCID Logo  ; Hillesland, Heidi K 2 ; Gilchrist, Carol A 3 ; Naulikha, Jaqueline M 4 ; McGrath, Christine J 5 ; Van Voorhis, Wesley C 5 ; Rwigi, Doreen 6 ; Singa, Benson O 6 ; Walson, Judd L 7 ; Pavlinac, Patricia B 5 

1  University of Maryland, Baltimore, Maryland, USA 
2  Hawai’i Pacific Health, Lihue HI 
3  University of Virginia, Charlottesville, Virginia, USA 
4  Maasai Mara University, Narok, Kenya 
5  University of Washington, Seattle, Washington, USA 
6  Kenya Medical Research Institute, Nairobi, Kenya 
7  University of Washington, Seattle, Washington, USA; Child Acute Illness and Nutrition (CHAIN) Network, Nairobi, Kenya 
Publication year
2020
Publication date
Dec 2020
Publisher
Oxford University Press
e-ISSN
23288957
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1093/ofid/ofaa533
ProQuest document ID
3170947007
Copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.