Some Epidemiological Aspects of Cryptosporidium parvum Among Children Below Five Years in Kirkuk Province

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Hiba Khider Askar
Yahya Jirjees Salman
AbdulKhaliq Alwan Mohiemeed


Cryptosporidium, gastroenteritis, Auramine, Calcofluor, Entamoeba


Background: Intestinal protozoan parasite infection impacted malnutrition, public health, and young children. The zoonotic pathogen Cryptosporidium spp. generates diarrhea in immunocompetent and immunocompromised hosts. Its global burden, epidemiology, diagnosis, and management are poorly understood.
Setting: A cross-sectional study of 330 under-5 years with gastroenteritis (177 men and 153 females).
Methodology: After each patient completed a questionnaire, stool samples were obtained for Modified Ziehl-Neelsen, direct microscopy, concentration, the flotation technique), and fluorescent stains.
Results: 204 stool samples had 61.68 percent Cryptosporidium. This rate involved: 65.35 percent in females against 58.75 percent in males (p > 0.05), although the association between male age and cryptosporidium frequency was significant (p 0.05). Samples from children under one year and one to two years had high rates of 32.35 percent and 26.24 percent, respectively, compared to older children. P<0.05. Artificially fed children had 43.07% Cryptosporidium compared to 16.93% breastfed; (P <0.05). Children drinking mineral sterile water and tank water had stool rates of 59.63 % and 35.79 %, respectively, compared to 4.58 % for municipal water; P<0.05. Alkaline stool samples had 26.31 percent cryptosporidiosis, p<0.05. Patient residency did not affect Cryptosporidium dispersion. Diarrhea-associated Cryptosporidium positivity was 62.26 percent compared to 37.74 percent in non-diarrheic stools, especially in infants under one year. Entamoeba histolytica (19.74%), Blastocystis hominis (9.8%), and Giardia lamblia (6.37%) were other frequent intestinal parasites. Cryptosporidium was easily visible using modified Ziehl-Neelsen, Calcofluor, and Auramine methods.
Conclusions: In Kirkuk Province, children under five had the most gastroenteritis due to Cryptosporidium parvum infection. Age, feeding, and water intake are factors.

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1. Osman, M., El Safadi, D., Benamrouz-Vanneste, S., Cian, A., Moriniere R, G and et al. Prevalence, transmission, and host specificity of Cryptosporidium spp. in various animal group from two French zoos. Parasitol Res.2017; 116(12):3419–3422.
2. Aniesona, A. T and Bamaiyi, P. H. (2014). Retrospective study of cryptosporidiosis among diarrhoeic children in the arid region of north-eastern Nigeria. Zoonoses anPublicHealth.2020 Health.2014;61(6):420-426.
3. Mor SM, Tzipori S. Cryptosporidiosis in children in sub-Saharan Africa: A lingering challenge. Clin Infect Dis. 2008;47:915-21.
4. Mengist HM, Taye B, Tsegaye A. Intestinal parasitosis in relation to CD4+T cells levels and anemia among HAART initiated and HAART naive pediatric HIV patients in amodel ART center in Addis Ababa, Ethiopia. PLoS ONE. 2015;10:e0117715.
5. World Health Organization. Diarrhea- Fact sheet.Available from : factsheets/fs330/en/. Accessed December 21, 2016.
6. CDC. Crypto Outbreaks Linked to Swimming Have Doubled since 2014. 2017. Available online: (accessed on 26 January 2021).
7. Smith, H.V.; Caccio, S.M.; Cook, N.; Nichols, R.A.; Tait, A. Cryptosporidium and Giardia as foodborne zoonoses. Vet. Parasitol. 2007,149, 29–40. [CrossRef].
8. Hall, V., Taye, A., Walsh, B., Maquire, H., Dave .and et al. A large outbreak of gastrointestinal illness at open water swimming event in the river Thames London. Epidemiol Infect. 2017 145(6):1246–1255.
9. Osman, N.F. Comparison between different laboratory methods in the diagnosis of Cryptosporidium parvum . Diploma dissertation in Lab. Tech. Coll.Med. Tikrit Univ.2000.
10. Kadir, M. A., Othman, N. F., & Salman, Y. G. (2004). Comparison Between The efficacy Of different laboratory methods for diagnosis of Cryptosporidium. The Iraqi Journal of Vet Med.2004 28(1), 244–256.
11. Salman, Y.J., Ali, L.S. 2013. Detection of some microbial infectious agents among children aged below two years in Kirkuk city. J. Kirkuk Med. Coll.,1(1): 53 61.
12. Salman, Y.J., Mustafa, M.I. 2013. Evaluation of the employment of four laboratory diagnostic methods in detecting Giardia lamblia among children in Kirkuk city. J. Kirkuk Med.Coll., 1(2): 52 60.
13. Salman, Y.J. 2014. Efficacy of some laboratory methods in detecting iardia lamblia and Cryptosporidium parvum in stool samples. Kirkuk Univ.J. Sci. Stud., 9(1): 7 17.
14. Salman, J., Al-Taee, A.A. and Abid, A.M. Role the employee of some biological stains in detecting Giardia lamblia among internal Iraqi displaced peoples in Kirkuk Province.Int. J. Curr.Microbiol Applied Sci.2016; 5: 705-718
15. Abdulrazaq, A.A. Detection of some physiology and immunological Helicobacter pylori and parameter related to some intestinal parasites among patients with gastrointestinal disorders in Kirkuk. Ph.D. Thesis, Tikrit University, Tikrit.Iraq.2017.
16. World Health Organization (1991) Basic laboratory methods in medical parasitology. W.H.O Geneva :16-17.
17. Salman, Y., Kadir ,M.A and Abdul-Allah,, T.J. Prevalence of Cyclospora cayetanensis and other intestinal parasites in soil samples collected from Kirkuk Province. Int. J. Curr. Res. Aca. Rev 2015a ., 3(10): 239 250.
18. Salman, Y.J. Detection of Blastocystis hominis among peoples in Kirkuk Province using ELISA and direct microscopy. Int. J. Curr.Microbiol. App. Sci.2015b 4(10): 686 695.
19. Abou El-Naga, .I.F. and Gaafar, M.R. Auramine-Phenol vs. Modified Kinyoun’s Acid Fast Stains for Detection of Coccidia Parasites. Lab Medicine. 2014;45(1):65-73.
20. Harrington BJ, Hageage GJ. Calcofluor white:A Review of its Uses and Applications in Clinical Mycology and Parasitology. Lab Med. 2003;5(34):361-7.
21. Llorente, M., Clavel, A., Varea, M., Olivera, S., Castillo, F. and et al. Evaluation of an immunochromatographic dip-strip test for the detection of Cryptosporidium oocysts in stool specimens. Eur J Clin Microbiol Infect Dis. 2002,21: 624-625.
22. Karyaghdi, T.K.N. Study the efficacy of some laboratory methods in diagnosis of intestinal parasite among infected peoples in Kirkuk city-Iraq. M.Sc. thesis, Coll. Sci. Kirkuk University-Iraq.2012.
23. Al-Baiti, Sh.R. Epidemiological study for detecting some intestinal parasites with histological study of Giardia lamblia on duodenum tissues in mice.M.Sc. thesis. Coll. Educ. Tikrit University-2011.
24. Salman, Y.J., Sadek, W.S. and Rasheed, Z.Kh.. Prevalence of Cryptosporidium parvum and other intestinal parasites among displaced peoples in Kirkuk Province. Int. J. Curr.Microbiol. App. Sci.2015c ;4(11):1-13.
25. Al-Amery, A. R. and Al-Amery, A. M. A. . “Molecular diagnosis of Cryptosporidium ssp. in water buffaloes at babylon province, iraq”, iraqi journal of agricultural sciences. 2022 ;53(1):147–156. doi: 10.36103/ijas.v53i1.1519.
26. Shahoi, H .I .A.; Mero, W.M.S. and Mohammad, A.B .Prevalence of cryptosporidiosis and its associated risk factors among human population in Zakho district, DUHOK PROVINCE, Kurdistan region, IRAQ.Sci J.Univ.Zakho.2022; 10(4): 153 –158.
27. Korpe,P.S., Haque, R., Gilchrist, C., Valencia, C., Niu, F.and et al. Natural history of cryptosporidiosis in a longitudinal study of slum-dwelling Bangladeshi children: association with severemalnutrition. PLoS Negl Trop Dis.2016 10:e0004564.
28. Kattula, D., Jeyavelu, N., Prabhakaran, A.D., Premkumar, P.S., Velusamy, V.and et al. Natural history of cryptosporidiosis in a birth cohort in Southern India. Clin Infect Dis. 2017; 64:347–354.
29. Delahoy, M.J., Omore, R., Ayers, T.L., Schilling, K.A., Blackstock, A.J.and et al. Clinical, environmental, and behavioral characteristics associated with Cryptosporidium infection among children with moderate-to-severe diarrhea
in rural western Kenya, 2008–2012: the Global Enteric Multicenter Study (GEMS). PLoS Negl Trop Dis .2018;12:e0006640.
30. Chen, Y.G., Yao, F.B., Li, H.S., Shi, W.S., Dai, M.X and Lu M. Cryptosporidium infection and diarrhea in rural and urban areas of jiangsu, people's republic of china. J. Clin. Microbiol. 1992;30:492–494. 22.
31. Al-Delaimy, A.K., Al-Mekhlafi, H.M., Nasr, N.A., Sady, H., Atroosh, W.Mand et al. Epidemiology of intestinal polyparasitism among orang asli school children in rural Malaysia. PLoS Negl. Trop. Dis. 2014;8:e3074. doi: 10.1371/journal.pntd.0003074.
32. Ajjampur, S.S., Liakath, F.B., Kannan, A., Rajendran P., Sarkar R. and et al. Multisite study of cryptosporidiosis in children with diarrhea in India. J. Clin. Microbiol. 2010;48:2075–2081. doi: 10.1128/JCM.0250909.
33. Al-Mohammed, H.I., Amin, T.T., Aboulmagd, E., Hablus, H.R and Zaza, B.O. Prevalence of intestinal parasitic infections and its relationship with socio–demographics and hygienic habits among male primary schoolchildren in Al–Ahsa, Saudi Arabia. Asian Pac. J. Trop. Med. 2010;3:906–912. doi: 10.1016/S1995-7645(10)60218-0.
34. Zheng,H., He,J., Wang, Li., Zhange ,R., Ding,Z and et al .Risk Factors and Spatial Clusters of Cryptosporidium Infection among School-Age Children in a Rural Region of Eastern China. Int. J. Environ. Res. Public Health 2018, 15, 924; doi:10.3390/ijerph15050924.
35. Wegayehu, T.; Adamu, H and Petros, B. Prevalence of giardia duodenalis and cryptosporidium species infections among children and cattle in north Shewa zone, Ethiopia. BMC Infect. Dis. 2013, 13, 419.
36. Al-Shamiri, AH., Al-Zubairy, AH and Al-Mamari, RF.The prevalence of Cryptosporidium spp. in children, Taiz district, Yemen. Iranian J Parasitol.2010;5(2): 26-32.
37. Salman , Y.J. Water contamination with protozoan parasites in Kirkuk Province. Journal of Applied Pharmaceutical Science . 2007;3(1):78-85.
38. Mirzaei, M. Prevalence of Cryptosporidium sp. infection in diarrhea and non-diarrheic humans in Iran. Korean J Parasitol.2007; 45 (2): 133-7.
39. Al-Shibani, LA., Azazy, AA and El-Taweel HA. Cryptosporidiosis and other intestinal parasites in 3 Yemeni orphanages: prevalence, risk and morbidity. J Egypt Sco Parasitol. 2009; 39 (1):327 -37.
40. Alder, S., Widersrom, M., Linddh ,J and Liliam M. Symptoms and risk factors ofCryptosporidium hominis infection in children: data from a large waterborne outbreak in Sweden .Parasitol Res. 2017; 116(10): 2613–2618.
41. Dharayath, S., Neelima, A., Umabala , P.K., Patil,M and Tega, V.D. Auramine rhodamine stain-a rapid and sensitive tool for detection of coccidian parasites. J Med Microb Diagn.2021;10(6):
42. Ali,O.S., Mohammad , Sh.A. and Salman, Y.J. Relationship between Entamoeba histolytica and Fecal Calprotectin in Patients with Gastroenteritis in Kirkuk City-Iraq. Egyptian Journal of Medical Microbiology.2018;27(2): 49-56 .