intestinal parasites causing diarrhoea in children aged 0-5 fidssa 2
TRANSCRIPT
UKZN INSPIRING GREATNESS
Intestinal protozoal parasites in children aged 0-5 years presenting
with diarrhoea in the eThekwini district of KwaZulu-Natal
Mathaparsadh, N. , Kwitshana, Z.L., Ashiru, O.T., Sturm, A.W. and Moodley, P.
School of Laboratory Medicine and Medical Sciences
Diarrhoea
• Major cause of morbidity and mortality1,9 million deaths p.a. in the 0-5 age group 78% occur in Africa and South-East Asia
• Risk factors living in rural areasno access to clean water improper sanitationmalnutrition lack of hygiene
• Intestinal parasitic infections are common globally
• Accounting for 3.5 billion infections majority children
• Intestinal protozoal parasites
Entamoeba histolyticaGiardia lambliaeCryptosporidium parvum
Cyclospora cayetanensisMicrosporidia spp. Isospora belliDientamoeba fragilisBalantidium coliBlastocystis hominis
Aim
• To determine and identify the prevalence of protozoal parasites in stool specimens of children ≤5 years of age, presenting at King Edward VIII Hospital, Durban
Methodology• Ethics approval
Ethics no. BE222/13
• Informed consent obtained
• Stool specimens from 249 patients preserved (5% formalin)detection of protozoa
Microscopic analyses• Smears prepared and stained with:
modified Ryan-Blue Trichrome stain modified Ziehl-Neelsen stain
• Viewed under light microscopyscan at 450 xconfirmation at 1000 x
Results
The prevalence of intestinal parasites stratified by
staining technique in children ≤ 5 years (n=249)
Technique No. (%) Detected G. lambliae C. parvum NPS
Ziehl-Neelsen stain 2 (1) 36 (15) 209 (84)
Trichrome stain 6 (3) 18 (7) 224 (90)
Total no. of positive 6 (3) 50 (20)patients
*NPS – No Protozoal Parasite Seen**G. lambliae stained blue in the ZN Stain
Discussion
• C. parvum prevalence correlates well with similar studies in Africa 20 - 30% prevalence
• C. parvum higher prevalence than G. lamblia 13% of study participants HIV positive17% of study participants exposed to HIV
• G. lamblia discordant with previous studies in KZN 23 – 75% prevalence (Kwitshana, 1999)
• But concordant with studies in Africa3 – 13 % prevalence
Limitations • single stool specimen collected
• stool collected from diapers which has urinedilutes the positive sampleprevents trophozoite motility
• stool specimens not always preserved within the 2hr recommended time-frame
• stool specimens could not be viewed immediately
Conclusion• In our study:
2 protozoal parasites prevalent Giardia lambliae and Cryptosporidium parvum
of these parasites C. parvum demonstrated a higher prevalence than G. lambliae
Acknowledgements• Patients• Clinical staff• Research nurses• Laboratory staff and fellow students• KZN DOH• CHS• NRF