Epidemiology of cryptosporidiosis in rural Malawi

Morse, Tracy and Nicholls, Rosely and Grimason, Anthony and Smith, Huw (2008) Epidemiology of cryptosporidiosis in rural Malawi. Environment & Health International. pp. 36-44. ISSN 1726-9210

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Abstract

A hospital and community based study was conducted in Malawi, within a rural population over a 23 month period, to identify the incidence, causative species and possible determinants for cryptosporidiosis in under fives. 5.9% (25/423) of samples collected were positive for Cryptosporidium oocysts of which 18 amplified by PCR-RFLP indicating the following species: C. hominis, C. parvum, C. meleagridis and C. andersoni. Consenting positive cases were included in a case control study. 96 home interviews were conducted in 24 communities (cases n=24; unmatched controls n=72). A total of 61 risk factors were investigated with a questionnaire, and combined with quantitative data from samples of domesticated animal stools and drinking water. Oocysts were not isolated from domesticated animals or water samples. Multivariate logistic regression of questionnaire data revealed an increased risk of cryptosporidiosis associated with ownership of pigs (OR 7.2, 95%CI 1.9–27.5, p=0.004), presence of diarrhoea in the household (OR 8.8, 95%CI 1.8–53.4, p=0.008), bathing in the river (OR 76.7, 95%CI 1.1–23.8, p=0.037) and no education within the household (OR 3.6, 95%CI 1.1–11.8, p=0.038). Bacteriological results indicating faecal contamination of both drinking water stored within the home (76%), and the surface of guardians’ hands (75%) were indicative of poor hygienic practices and potential sources of infection.

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