Özet:

Purpose: Diarrhoea in children is a common problem in low resourced countries including Malawi. It is caused by many intestinal parasites including Cryptosporidium parvum and Isospora belli. Both infections are prevalent in severely immunocompromised individuals and may cause severe life-threatening diarrhoea. The main aim of the study was to assess the prevalence of Cryptosporidium parvum and Isospora belli infections among children presenting with diarrhoea admitted to QECH - paediatrics wards and methods used for diagnosis. Some specific objectives were to determine the prevalence of Cryptosporidium parvum and Isospora belli infections among human immunodeficiency virus (HIV) seropositive and HIV seronegative children with diarrhoea, to evaluate diagnostic methods used at QECH to identify intestinal parasites and to determine diagnostic methods that can be recommended for implementation. Methods: Faecal samples were collected from all children presenting with diarrhoea upon admission or already hospitalised were recruited excluding all children without or with acute diarrhoea (less than three days). Four smears were prepared from each sample: 2 for Ziehl Neelsen staining and the other 2 for Auramine-phenol staining. The data was entered into Microsoft Excel and analysed using Epi-Info. Results: A total of 25 children with diarrhoea under the age of five years; 10 were human immunodeficiency virus -seropositive, 7 were HIV-seronegative and 8 of them their status was unknown. Cryptosporidium parvum was detected in 4 children (16%) at 4.5% and 36.1% confidence intervals and none had Isospora belli at 0.0% and 86.3% confidence intervals. Out of those 4 who had Cryptosporidium parvum, 3 children were HIV-seropositive and 1 child was HIV-seronegative at a frequency of 30% and 14.3% respectively. No infection was seen in children whose HIV-serostatus was unknown. Conclusion: Modified Ziehl Neelsen technique and auramine-phenol staining can be used to examine stool at QECH for C.parvum and I.belli identification. Although I.belli is prevalent in our environment, it has not yet been detected in children and or evolved as an endemic pathogen and so far remains as an opportunistic pathogen in adults only. There is need to repeat the study in rainy season and include gold standard method.

Anahtar Kelimeler: