Prevalence and Risk Factors for Cryptosporidium Diarrhea among Children Aged Five Years and below in Selected Health Institutions in Abakaliki, South-East Nigeria

Abstract

Background : Diarrheal diseases have globally decreased over the past few decades, yet they remain one of the top three causes of mortality in children under five years, especially in sub-Saharan Africa and Nigeria. Seasonal peaks of diarrheal episodes continue to contribute significantly to childhood mortality in these regions. One of the notable causes of diarrhea in children is parasitic infections, particularly Cryptosporidium , which poses a serious health risk. In Nigeria, the burden of Cryptosporidium diarrhea is under-researched, making it imperative to investigate its prevalence and associated risk factors. Study Objectives : The study aims to determine the prevalence and risk factors associated with Cryptosporidium diarrhea among children aged five years and below in selected health institutions in Abakaliki, South-East Nigeria. Methodology : This cross-sectional study was conducted from January to May 2017, recruiting 200 children under five years with diarrhea from health institutions in Abakaliki. Fecal specimens were analyzed for Cryptosporidium oocysts using light microscopy with modified Ziehl-Neelsen staining and immunofluorescent antibody test (IFAT). Deoxyribonucleic acid (DNA) was extracted from positive samples using QIAmp® DNA stool kit, followed by Polymerase Chain Reaction (PCR) and molecular genotyping. Results : Cryptosporidium was detected in 0.5% (1/200) of children via light microscopy and 6.5% (13/200) via IFAT. All positive samples were confirmed as Cryptosporidium hominis by PCR. The prevalence of infection was significantly higher in children from institutionalized homes (50.0%) compared to monogamous homes (6.2%) (p < 0.05). Other associated risk factors included male gender, urban residence, absence of exclusive breastfeeding, caregiver being a nanny, and maternal lack of formal education. Conclusion : Cryptosporidium hominis is a notable cause of diarrhea among children in Abakaliki, primarily transmitted through human-to-human contact. The study underscores the need for targeted interventions in childcare institutions to prevent outbreaks. Health authorities should promote breastfeeding and enhance education on hygiene practices in vulnerable populations.