Cryptosporidiosis in malnourished children at Kenyatta National Hospital

Abstract

Cryptosporidiosis in malnourished children at the Paediatric Emergency Ward (PEW) of Kenyatta National Hospital was studied. This was done over a three months period, September to December 1989. Two hundred and eighty five patients were studied, 24 of whom were HIV positive. Their age range was 14 days - 60 months, with a mean range of 17 months. The male to female ratio was 1:1.1. Among the 256 patients negative for HIV, 46 had Cryptosporidium oocyts in stool giving a prevalence of 18%. These were 22 males and 24 females giving a M:F ratio of 1:1.1. Their age range was 8 to 37 months with a mean age of 18.2 months and a median of l6 months. The highest prevalence occurred in patients with marasmic-kwashiork9r (21.7%) followed by underweight, kwashiorkor and marasmus with 20.3%, 18.4% and·10.5% respectively. Ninety nine (38.7%) of the 256 patients had diarrhoea. Eighteen (18%) of the ninety nine were positive for Cryptosporidium as were 28 (18%) of the 157 without diarrhoea. 2 Fever (Temp. > 37.5°C) was present in 93 out of the 256 forming 36.7%. Among these with fever, 17.2% were Cryptosporidial positive compared to 18.4% Cryptosporidial positive with no fever. Out of 256 patients, 30 had measles, 90% of which occurred within 6 weeks prior to the study. Nine of these were Cryptosporidial positive giving a prevalence of 30% compared to 16.4% in the non-measles cases. HIV results were available for 285 patients. Of e these, 24 were HIV positive giving a prevalence of 8.4% among the malnourished children. Two (8.3%) out of 24 HIV positive patients had Cryptosporidium oocyts in stool. The report of this study shows the Cryptosporidium is highly prevalent in Kenyan malnourished children. We therefore recommend routine laboratory examination for Cryptosporidium in stool specimens of malnourished children.