Epidemiology of cryptosporidiosis in rural Malawi

Tracy Morse, Rosely Nicholls, Anthony Grimason, Huw Smith

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Abstract

A hospital and community based study was conducted in
Malawi, within a rural population over a 23 month
period, to identify the incidence, causative species and
possible determinants for cryptosporidiosis in under
fives. 5.9% (25/423) of samples collected were positive
for Cryptosporidium oocysts of which 18 amplified by
PCR-RFLP indicating the following species: C. hominis,
C. parvum, C. meleagridis and C. andersoni. Consenting
positive cases were included in a case control study. 96
home interviews were conducted in 24 communities
(cases n=24; unmatched controls n=72). A total of 61 risk
factors were investigated with a questionnaire, and
combined with quantitative data from samples of
domesticated animal stools and drinking water. Oocysts
were not isolated from domesticated animals or water
samples. Multivariate logistic regression of questionnaire
data revealed an increased risk of cryptosporidiosis
associated with ownership of pigs (OR 7.2, 95%CI
1.9–27.5, p=0.004), presence of diarrhoea in the
household (OR 8.8, 95%CI 1.8–53.4, p=0.008), bathing
in the river (OR 76.7, 95%CI 1.1–23.8, p=0.037) and no
education within the household (OR 3.6, 95%CI
1.1–11.8, p=0.038). Bacteriological results indicating
faecal contamination of both drinking water stored
within the home (76%), and the surface of guardians’
hands (75%) were indicative of poor hygienic practices
and potential sources of infection.
Original languageEnglish
Pages (from-to)36-44
Number of pages9
JournalEnvironment & Health International
Publication statusPublished - 2008

Keywords

  • epidemiology
  • rural Malawi
  • cryptosporidiosis

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