Epidemiology, Genetic Diversity and Diagnostic Procedures of Cryptosporidium Species in Bungoma County, Kenya

Abstract

Across-sectional study on prevalence of cryptosporidiosis was carried out in Bungoma County, Western region of Kenya. The main objective of the study was to determine the epidemiology, genetic diversity and diagnostic procedures of Cryptosporidium species in Bungoma County, Kenya. A total of 712 fecal samples from children up to five years of age were collected, from four Hospitals in Bungoma County, Western Kenya over a period of 30 months covering January 2011 to June 2013. Overall prevalence of cryptosporidiosis in children was 5.1 %. Peak prevalence was observed between June and July, with a smaller peak between October and November in both 2011 and 2012. Genotype analysis based on Polymerase Chain Reaction- restriction fragment length polymorphism (PCR-RFLP) of the 18S rRNA gene fragment revealed that among the Cryptosporidium positive patients of study group 38.89% (N=36) of the isolates were C. hominis 36.11% were C. parvum, while the prevalence of C. meleagridis and C. canis was 16.67% and 5.56% respectively. Cryptosporidiosis was significantly associated with diarrhea (OR=1.7793, CI=0.3670-1.6650, P=0.03164) and Abdominal swelling and pain, (OR=1.4711, CI=0.5680- 1.6202, P=0.04926). However, other symptoms such as headache, cough, fever and vomiting were not significantly associated with cryptosporidiosis, in the study groups. There were no significant sex related differences observed in the cryptosporidiosis prevalence in the children (P=0.119). However environmental factors such as water sources and treatment, or presence of livestock in homesteads were significantly associated with cryptosporidiosis. The results suggest that cryptosporidiosis prevalence is comparable to other regions of the world with C. hominis being the most common species circulating in the study area followed by C. parvum and C. meleagridis in that order. These results also suggest that both animals to human and human-to-human transmission are the main modes of spread of cryptosporidiosis in the region. The presence of animal species of Cryptosporidium such as C. canis in the study patients also suggested that animal reservoirs may still be an important link in the transmission dynamics of Cryptosporidium spp. It is therefore recommended that diagnosis of Cryptosporidium spp be included as a mandatory test during routine examination of stool specimens for ova and parasites, and that mitigation effort against the disease should focus on preventive measures, research for an effective drug against the parasite, and that mitigation against the disease should focus on preventive measures that include research on effective drugs against Cryptosporidium and other intestinal parasites.