Risk Factors and Circulating Subtypes of Cryptosporidium spp. and Giardia duodenalis in Hospitalized Children in Mozambique.

Abstract

Cryptosporidium spp. and Giardia duodenalis are important diarrheal agents in children in developing countries. Little is known about their molecular epidemiology; as such, the objective of this study was to determine the risk factors and genetic diversity of both parasites in diarrheal samples in Mozambique. In this study, two nested PCRs targeting ssurRNA and gp60 genes were used for genetic diversity of Cryptosporidium spp. and b-giardin for G. duodenalis. Sociodemographic and clinical characteristics were obtained through questionnaires. The location (odds ratio [OR] 3.499), mother's education level (OR 2.150) and age were significant factors for acquiring infection by Cryptosporidium spp. (p < 0.05). Cryptosporidium hominis was the predominant (77.8%) species. Four families (three C. hominis and one C. parvum) were identified, with the highest for Ib (73.9%), followed by Id (13%), Ia (8.7%) and IIc (4.3%). The location (p-value < 0.001), drinking untreated water (p-value = 0.04) and living in masonry houses (p-value = 0.002) were identified as risks associated with G. duodenalis infection. Assemblage A was the dominant type (65.2%). Among the subassemblages of assemblage A, AII was the most frequent (86.6%), followed by AIII (6.6%). For assemblage B, subassemblages BIII (87.5%) and BIV (12.5%) were identified. The dominance of the subtype IbA9G3 of C. hominis, as well as the AII subassemblage of G. duodenalis, seems to indicate that the transmission of both protozoa occurs mainly through the anthroponotic route.