• Shahina Mumtaz
  • Jawad Ahmed
  • Liaqat Ali
  • Hamid Hussain


Background: Cryptosporidium parvum is an emerging pathogen responsible for chronic diarrhoea inchildren and immuno-compromised individuals, especially AIDS patients. Currently, there is noeffective therapeutic strategy for treating cryptosporidiosis, therefore control and supportivetreatment of cryptosporidiosis depends upon rapid and accurate diagnosis of this infection.Methodology: A descriptive study was conducted in the Pathology Department of Khyber MedicalCollege and Pathology Laboratory of Khyber Teaching Hospital over a period of one year March2007–April 2008. A total of 200 stool samples were tested for the presence of C. parvum oocystsfrom children <5 years age suffering from diarrhoea for >5 days. Total and differential leukocytecount was determined to assess immune status of the patients. Modified Ziehl-Neelsen (Z-N)staining, a rapid, sensitive and easy test, was used successfully for the detection of C. parvumoocysts in stool specimen. Results: Cryptosporidium oocysts were found in 18 (9.0%) samples. Outof 18 positive cases, 13 (72.2%) children had lymphopenia hence their immune status was impaired.Infection was common in children between 1–24 months of age. Mean duration of diarrhoea was 11months. Most of C. parvum infected children were consumers of well water (77.8%). Conclusion:Cryptosporidiosis, although a self-limiting disease, rarely investigated routinely, can become chronicand life threatening in immuno-compromised individuals. Majority of affected patients are immunecompromised. Modified Z-N is a sensitive and rapid method which can explore the gravity of thisinfection even further if used routinely and may control morbidity and mortality associated with thisinfection.Keywords: Chronic diarrhoea, modified Ziehl-Neelsen staining, immuno-comprised


Shoaib S, Tauheed S, Hafiz A. Frequency of Cryptosporidium in

childhood diarrhoea importance of modified acid fast technique. J

Ayub Med Coll Abbottabad 2003;3:3–5.

Chappell CL, Okhuysen PC, Cryptosporidiosis. Current Opin

Infect Dis 2005;15:523–7.

Guerrant RL. Cryptosporidiosis: an emerging highly infectious

threat. Emerg Infect Dis 1997;3:51–7.

Bhutta, ZA. Persistent diarrhoea in developing countries. Ann

Nestle 2006;64:39–47.

Thielman NM, Guerrant RL. Acute infectious diarrhoea. N Eng J

Med 2004;350:38–47.

Vakil NB, Schwartz SM, Buggy BP, Brummitt CF, Kherellah M,

Letzer DM, et al. Biliary cryptosporidiosis in HIV infected

people after the water borne outbreak of Cryptosporidiosis in

Milwaukee. N Eng J Med 1996;334:19–23.

Roy SL, Delong SM, Stenzel SA, Shiferaw B, Roberts JM,

Khalakdina A, et al. Risk factor for sporadic Cryptosporidiosis

among immuno-competent persons in the United States from

to 2001. J Clin Microbiol 2004;42:2944–51.

Gaash B. Cryptosporidiosis. Ind Medica 2006;3:1–7.

Ajjampur SSR, Gladstone BP, Selvar D, Muliyil P, Ward H,

Kang G. Molecular and spatial epidemiology of cryptosporidiosis

in semi urban community in South India. J Clin Microbiol


Banwat EB, Egah DZ, Audu ES, Onile BA, Datong PR.

Cryptosporidium infection in undernourished children with

HIV/AIDS in Jos, Nigeria. Annals Afr Med 2004;3:80–2.

Mahgoub ES, Al-Mahbashi A, Abdulatif B. Cryptosporidiosis in

children in North Jordanian Paediatric Hospital. Eastern Mediter

Health J 2004;10:494–501.

Iqbal J, Munir MA, Khan MA. Cryptosporidium infection in

young children with diarrhoea in Rawalpindi, Pakistan. Am J

Trop Med Hyg 1999;60:868–70.

Morgan UM, Pallant L, Dwyer BW, Forbes DA, Rich G,

Thompson RCA. Comparison of PCR and microscopy for

detection of Cryptosporidium parvum in human fecal specimens,

Clinical trial. J Clin Microbiol 1998;36:995–8.

Agnew DG, Lima AAM, Newman RD, Wuhib T, Moore RD,

Guerrant RL, Sears CL. Cryptosporidiosis in Northeastern

Brazilian children: association with increased diarrhoeal

morbidity. J infect Dis 1998;177:754–60.

Laubach HE, Bentlay CZ, Ginter EL, Spalter JS, Jensen LA. A

study of risk factors associated with the prevalence of

Cryptosporidium in villages around lake Atitlan, Guatemala.

Braz J Infect Dis 2004;8:1–7.

Rashidul-Haque. Human intestinal parasites. J Health Popul

Nutri 2007;25:387–91.

Mahdi NK, Al-Sadoon IA, Mohamed AT. First report of

cryptosporidiosis among Iraqi children. Eastern Mediter Health J


Abu Alrub SM, Abusada GM, Farraj MA, Essawi TA.

Prevalence of Cryptosporidium spp. in children with diarrhoea in

the west Bank Palestine. J Infect Develop Countr 2008;2:59–62.

Nimri LF, Batchoun R. Prevalence of cryptosporidium species in

elementary school children. J Clin Microbiol 1994;32:1040–2.

Newman RD, Zu S-X, Wuhib T, Lima AAM, Guerrant RL,

Sears CL. Household epidemiology of Cryptosporidium parvum

infection in an urban community in Northeast Brazil. Annal Inter

Med 1994;120:500–5.

Baqai R, Anwar S, Kazmi SU. Detection of cryptosporidium in

immune-suppressed patients. J Ayub Med Coll Abbottabad


Nagamani K, Pavuluri PRR, Gyaneshwari M, Prasanthi K, Rao

MIS, Saxena NK. Molecular characterization of

Cryptosporidium: an emerging Parasite. Indian J Med Microbiol




Most read articles by the same author(s)