Case-Control Study of Cryptosporidium Transmission in Bangladeshi Households

Poonum Korpe, Carol Gilchrist, Cecelia Burkey, Mami Taniuchi, Emtiaz Ahmed, Vikram Madan, Rachel Castillo, Shahnawaz Ahmed, Tuhinur Arju, Masud Alam, Mamun Kabir, Tahmeed Ahmed, William A. Petri, Rashidul Haque, A. S.G. Faruque, Priya Duggal

Research output: Contribution to journalArticle

Abstract

Background Cryptosporidium is a leading contributor to diarrheal morbidity and mortality in under-5 children worldwide. As there is no vaccine and no effective drug therapy in young children for this infection, preventing infection is critical. We undertook a pilot case-control study to define the extent of person-to-person transmission of cryptosporidiosis within an urban and a rural community in Bangladesh. Methods We enrolled 48 case families with a Cryptosporidium-infected child aged 6-18 months. Controls were age- and sex-matched Cryptosporidium-negative children in 12 households. Children and household members were followed for 8 weeks with weekly illness survey and stool testing with quantitative polymerase chain reaction for Cryptosporidium. Results In the 24 urban case families, the secondary attack rate was 35.8% (19/53) vs 0% (0/11) in controls (P =.018, Ï ‡ 2 test). In contrast, in the 24 rural case families, the secondary attack rate was 7.8% (5/64) vs 0% (0/21) in controls (P =.19, Ï ‡ 2 test). Genotyping by gp60 demonstrated infection with the same subspecies in 5 families, and evidence of transmission in 2. Serologic response to Cryptosporidium infection was associated with younger age, longer duration of infection, and Cryptosporidium hominis gp60-IbA9G3R2 infection. Conclusions In the urban site, the high rate of secondary infection and infection with the same subspecies within families suggests that person-to-person transmission is a major source of Cryptosporidium infection for young children living in this region. Molecular genotyping can be applied to determine transmission of Cryptosporidium in endemic regions. Further work is needed to understand the differences in parasite transmissibility and immunity to different genotypes.

Original languageEnglish (US)
Pages (from-to)1073-1079
Number of pages7
JournalClinical Infectious Diseases
Volume68
Issue number7
DOIs
StatePublished - Mar 19 2019

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Cryptosporidium
Case-Control Studies
Infection
Cryptosporidiosis
Bangladesh
Rural Population
Coinfection
Immunity
Parasites
Vaccines
Genotype
Morbidity
Drug Therapy
Polymerase Chain Reaction
Mortality

Keywords

  • Cryptosporidium hominis
  • Cryptosporidium meleagridis
  • Cryptosporidium parvum
  • diarrhea
  • transmission

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Case-Control Study of Cryptosporidium Transmission in Bangladeshi Households. / Korpe, Poonum; Gilchrist, Carol; Burkey, Cecelia; Taniuchi, Mami; Ahmed, Emtiaz; Madan, Vikram; Castillo, Rachel; Ahmed, Shahnawaz; Arju, Tuhinur; Alam, Masud; Kabir, Mamun; Ahmed, Tahmeed; Petri, William A.; Haque, Rashidul; Faruque, A. S.G.; Duggal, Priya.

In: Clinical Infectious Diseases, Vol. 68, No. 7, 19.03.2019, p. 1073-1079.

Research output: Contribution to journalArticle

Korpe, P, Gilchrist, C, Burkey, C, Taniuchi, M, Ahmed, E, Madan, V, Castillo, R, Ahmed, S, Arju, T, Alam, M, Kabir, M, Ahmed, T, Petri, WA, Haque, R, Faruque, ASG & Duggal, P 2019, 'Case-Control Study of Cryptosporidium Transmission in Bangladeshi Households', Clinical Infectious Diseases, vol. 68, no. 7, pp. 1073-1079. https://doi.org/10.1093/cid/ciy593
Korpe, Poonum ; Gilchrist, Carol ; Burkey, Cecelia ; Taniuchi, Mami ; Ahmed, Emtiaz ; Madan, Vikram ; Castillo, Rachel ; Ahmed, Shahnawaz ; Arju, Tuhinur ; Alam, Masud ; Kabir, Mamun ; Ahmed, Tahmeed ; Petri, William A. ; Haque, Rashidul ; Faruque, A. S.G. ; Duggal, Priya. / Case-Control Study of Cryptosporidium Transmission in Bangladeshi Households. In: Clinical Infectious Diseases. 2019 ; Vol. 68, No. 7. pp. 1073-1079.
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AU - Korpe, Poonum

AU - Gilchrist, Carol

AU - Burkey, Cecelia

AU - Taniuchi, Mami

AU - Ahmed, Emtiaz

AU - Madan, Vikram

AU - Castillo, Rachel

AU - Ahmed, Shahnawaz

AU - Arju, Tuhinur

AU - Alam, Masud

AU - Kabir, Mamun

AU - Ahmed, Tahmeed

AU - Petri, William A.

AU - Haque, Rashidul

AU - Faruque, A. S.G.

AU - Duggal, Priya

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Y1 - 2019/3/19

N2 - Background Cryptosporidium is a leading contributor to diarrheal morbidity and mortality in under-5 children worldwide. As there is no vaccine and no effective drug therapy in young children for this infection, preventing infection is critical. We undertook a pilot case-control study to define the extent of person-to-person transmission of cryptosporidiosis within an urban and a rural community in Bangladesh. Methods We enrolled 48 case families with a Cryptosporidium-infected child aged 6-18 months. Controls were age- and sex-matched Cryptosporidium-negative children in 12 households. Children and household members were followed for 8 weeks with weekly illness survey and stool testing with quantitative polymerase chain reaction for Cryptosporidium. Results In the 24 urban case families, the secondary attack rate was 35.8% (19/53) vs 0% (0/11) in controls (P =.018, Ï ‡ 2 test). In contrast, in the 24 rural case families, the secondary attack rate was 7.8% (5/64) vs 0% (0/21) in controls (P =.19, Ï ‡ 2 test). Genotyping by gp60 demonstrated infection with the same subspecies in 5 families, and evidence of transmission in 2. Serologic response to Cryptosporidium infection was associated with younger age, longer duration of infection, and Cryptosporidium hominis gp60-IbA9G3R2 infection. Conclusions In the urban site, the high rate of secondary infection and infection with the same subspecies within families suggests that person-to-person transmission is a major source of Cryptosporidium infection for young children living in this region. Molecular genotyping can be applied to determine transmission of Cryptosporidium in endemic regions. Further work is needed to understand the differences in parasite transmissibility and immunity to different genotypes.

AB - Background Cryptosporidium is a leading contributor to diarrheal morbidity and mortality in under-5 children worldwide. As there is no vaccine and no effective drug therapy in young children for this infection, preventing infection is critical. We undertook a pilot case-control study to define the extent of person-to-person transmission of cryptosporidiosis within an urban and a rural community in Bangladesh. Methods We enrolled 48 case families with a Cryptosporidium-infected child aged 6-18 months. Controls were age- and sex-matched Cryptosporidium-negative children in 12 households. Children and household members were followed for 8 weeks with weekly illness survey and stool testing with quantitative polymerase chain reaction for Cryptosporidium. Results In the 24 urban case families, the secondary attack rate was 35.8% (19/53) vs 0% (0/11) in controls (P =.018, Ï ‡ 2 test). In contrast, in the 24 rural case families, the secondary attack rate was 7.8% (5/64) vs 0% (0/21) in controls (P =.19, Ï ‡ 2 test). Genotyping by gp60 demonstrated infection with the same subspecies in 5 families, and evidence of transmission in 2. Serologic response to Cryptosporidium infection was associated with younger age, longer duration of infection, and Cryptosporidium hominis gp60-IbA9G3R2 infection. Conclusions In the urban site, the high rate of secondary infection and infection with the same subspecies within families suggests that person-to-person transmission is a major source of Cryptosporidium infection for young children living in this region. Molecular genotyping can be applied to determine transmission of Cryptosporidium in endemic regions. Further work is needed to understand the differences in parasite transmissibility and immunity to different genotypes.

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KW - Cryptosporidium meleagridis

KW - Cryptosporidium parvum

KW - diarrhea

KW - transmission

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