Diarrhea due to Cryptosporidium parvum in immunocompromised and immunocompetent patients in Khartoum State
Objective: The objective of this study is to search for Cryptosporidium parvum in Sudanese immunocompromised and immunocompetent patients presenting with diarrhea.
Methods: Two hundred and thirteen stool specimens were collected from different groups of patients presenting with diarrhea and healthy control (immunocompromised: 78; immunocompetent: 90; Control: 45).
The immunocompromised group included 25 HIV positive patients, 27 tuberculosis patients, 11 patients with renal failure and 15 patients receiving immunosuppressive chemotherapy. Antigen ELISA was performed to detect the presence of the parasite in stool. Positive specimens were examined by the modified ZN stain to look for the oocyst of C.parvum.
Result: Seventy one of the immunocompromised patients (91.0%), twenty nine of immunocompetent patients (32.2 %) and ten of the control group (22.2%) were found to be positive for C.parvum. A significant difference was noticed between the immunocompromised patients and the other groups (P<0.05). Among the immunocompromised patients, the highest percentage of positive results (96.1%) was in the HIV patients. The percentage of positive results within the tuberculosis, renal failure and immunosuppressive patients were 92.6%, 83.3% and 86.6% respectively.
Conclusion: The significant detection of C. parvum among the different groups of immunocompromised should raise the awareness of the clinicians towards this parasite as an important cause of diarrhea in such groups of patients.
Key words: chemotherapy, C. parvum, tuberculosis, renal failure.