Intestinal parasites causing diarrhoea in children aged 0-5 FIDSSA 2

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

Thank you