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Manifestaciones clínicas y factores de riesgo asociados a la infección por Cryptosporidium en pacientes de Barranquilla y tres municipios del Atlántic

Salud UNINORTE;23(1):19-31, jul. 2007

De la Ossa Merlano, Napoleón; Falconar, Andrew; Llinás Solano, Humberto J; Romero Vivas, Claudia M.

Objectives: To characterize the clinical manifestations and risk factors associated with cryptosporidiosis.Materials and methods: A descriptive study was performed on 423 patients, with macroscopic and microscopic faecal sample analyses, to identify the clinical manifestations and risk factors associated with cyptosporidiosis in 3 towns and the principal city in Atlantico(Colombia) over a 4-month period. Cryptosporidium spp oocysts were identified after stainingwith modified Ziehl-Neelsen. A saturated NaCl parasite-concentration method was also compared with wet-mount method for the detection of all intestinal parasites in 279/423 (66.0 percent) patients. Statistical analyses were performed using EPI-INFO 6.04.Results: The prevalence of Cryptosporidium spp. was 1.9percent (8/423). Statistical associationswere found between cryptosporidiosis infections and fever (p=0.01), blood in the faecalsamples (p=0.01) and the presence of household animals (p=0.02). Most of the patients(267/423: 63.1percent) were positive for intestinal parasites. The most commonly identifiedparasites were the non-pathogenic protozoa, Entamoeba coli (118/423: 27.9percent) and Endolimaxnana (86/423: 20.3percent), followed by Blastocystis hominis (76/423: 18percent), Entamoebahistolytica/dispar (28/423: 6.6percent) and Giardia lamblia (23/423: 5.4percent). Ascaris lumbricoides(6/423: 1.4percent) was the most common helminth identified. Sensitivities/specificities of99.4percent/95.2percent and 87.5percent/99.6percent were obtained for protozoa and helminths respectivelyusing the saturated NaCl method.Conclusions: Patients with cryptosporidiosis had fever and bloody faecal samples, andwere probably infected by domestic animals. Microscopy, using the modified Ziehl-Neelsenstain, was essential for Cryptosporidium spp. oocyst identification. The saturated NaClmethod efficiently concentrated the parasites. (AU)
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