Intestinal protozoa in hospitalized under-five children with diarrhoea in Nampula – a cross-sectional analysis in a low-income setting in northern Mozambique

Adilson Fernando Loforte Bauhofer, Idalécia Laurinda Carlos Cossa-moiane, Selma Domingos Amadeu Marques, Esperança Lourenço Alberto Mabandan Guimarães, Benilde António Munlela, Elda Muianga Anapakala, Jorfélia José Chiláule, Marta Cassocera, Jerónimo Souzinho Langa, Assucênio Chissaque, Júlia Assiat Monteiro Sambo, Lena Vânia Manhique-coutinho, Diocreciano Matias Bero, Timothy Allen Kellogg, Luzia Augusta Pires Gonçalves, Nilsa De Deus

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In Mozambique, infection by intestinal parasites is reported all over the country. However, infection in children with diarrhoea is mostly focused in the southern region of Mozambique. This work aims to determine the frequency and potential risk factors for infection by Cryptosporidium spp., Giardia lamblia, and Entamoeba histolytica in children under-five years hospitalized with diarrhoea in Hospital Central de Nampula, northern Mozambique. Methods: A cross-sectional hospital-based surveillance was conducted between March 2015 and January 2018 in children admitted with diarrhoea in Hospital Central de Nampula. Sociodemographic information was obtained through semi-structured interviews applied to the children’s caregivers. A single stool sample was collected from each child to detect antigens from Cryptosporidium spp., G. lamblia, and E. histolytica using an immune-enzymatic technique. Crude and adjusted odds ratios (with 95% Confidence Intervals) were obtained by logistic regression models to identify factors associated with infection by Cryptosporidium spp. and G. lamblia. Results: The median age and interquartile intervals of our sample population was 12 months (8–20). Intestinal protozoa were detected in 21.4% (59/276). Cryptosporidium spp. was the most common protozoa (13.9% - 38/274), followed by G. lamblia (9.1% - 25/274) and E. histolytica (0.4% - 1/275). Children with illiterate caregiver’s (p-value = 0.042) and undernourished (p-value = 0.011) were more likely to be infected by Cryptosporidium spp. G. lamblia was more common in children living in households with more than four members (p-value = 0.039). E. histolytica was detected in an eleven month’s child, co-infected with Cryptosporidium spp. and undernourished. Conclusion: Cryptosporidium spp. and Giardia lamblia were the most common pathogenic intestinal protozoa detected in children with diarrhoea hospitalized in the Hospital Central de Nampula. Our findings obtained highlight the importance of exploring the caregiver’s education level, children’s nutritional status for infections with Cryptosporidium spp., and living conditions, namely crowded households for infections with G. lamblia in children younger than five years.

Original languageEnglish
Article number201
Pages (from-to)201-208
Number of pages8
JournalBMC Infectious Diseases
Volume21
Issue number1
DOIs
Publication statusPublished - 23 Feb 2021

Keywords

  • Diarrhoea
  • Children
  • Intestinal Protozoa
  • Related factors
  • Low-income setting
  • Nampula province
  • Mozambique

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