Prevalence of Cyclospora cayetanensis among symptomatic and asymptomatic immune-competent children less than five years of age in Alexandria, Egypt

Peer review under responsibility of Alexandria University Faculty of Medicine.

Available online 24 April 2012

Figures & data

Figure. 1 Cyclospora cayetanensis oocyst (arrows) in stool samples stained with Modified Ziehl–Neelsen stain ×1000.

Table 1 Different parasites detected in stool samples from diarrheic and nondiarrheic children included in this study.

	Group I		Group II		Total		Test of sig.
	No.	%	No.	%	No.	%
Cyclospora cases
Pure	12	12.0	6	6.0	18	9.0	p = 0.138 FEp = 0.059
Mixed (Cyclospora + Cryptosporidia)	5	5.0	0	0.0	5	2.5
Cryptosporidia	5	5.0	0	0.0	5	2.5	FEp = 0.059
Giardia lamblia	2	2.0	1	1.0	3	1.5	FEp = 1.000
Microsporidia	5	5.0	0	0.0	5	2.5	FEp = 0.059
Hymenolepis nana	1	1.0	0	0.0	1	0.5	FEp = 1.000
No parasite	70	70.0	93	93.0	163	81.5	p < 0.001^*
Total	100	100.0	100	100.0	200	200.0

Group I: cases with diarrhea Group II: nondiarrheic cases.

FEp: Fisher Exact test.

* Statistically significant at p ⩽ 0.05.

Table 2 Demographic data of Cyclospora positive and negative cases among symptomatic and asymptomatic groups.

	Group I				Group II
	−ve		+ve		−ve		+ve
	No.	%	No.	%	No.	%	No.	%
Sex
Male	58	65.9	7	58.3	50	53.0	6	100.0
Female	30	34.1	5	41.7	44	46.8	0	0.0
Test of sig.	p = 0.606				FEp = 0.033^*
Age
<2 years	75	85.2	10	83.3	60	63.8	2	33.3
⩾2 years	13	14.8	2	16.7	34	36.2	4	66.7
Test of sig.	1.000				FEp = 0.179
Range of age	1.0–59.0		2.0–36.0		1.0–42.0		3.0–35.0
Mean ± SD	13.05 ± 15.82		12.75 ± 10.44		16.18 ± 12.64		21.0 ± 14.64
Median	7.0		8.0		12.0		25.0
Test of sig.	0.523				MWp = 0.581
Residency
Urban	29	30.0	3	25.0	94	100.0	6	100.0
Rural	59	67.0	9	75.0	0	0.0	0	0.0
Test of sig.	0.747				–

Group I: cases with diarrhea Group II: nondiarrheic cases.

MWp: p value for Mann–Whitney test.

FEp: p value for Fisher Exact test.

* Statistically significant at p ⩽ 0.05.

Table 3 Relation between Cyclospora positive and negative cases and type of feeding in symptomatic and asymptomatic groups.

	Group I				Group II
	−ve		+ve		−ve		+ve
	No.	%	No.	%	No.	%	No.	%
Feeding
Breast feeding	48	54.5	4	33.3	60	63.8	4	66.7
Formula feeding	39	44.3	8	66.7	34	36.2	2	33.3
Cow milk	1	1.1	0	0.0	0	0.0	0	0.0
Test of sig.	MCp = 0.309				FEp = 1.000

Group I: diarrheic cases Group II: nondiarrheic cases.

MCp: p value for Monte Carlo test.

FEp: p value for Fisher Exact test.

Table 4 Relation between Cyclospora and anthropometric measures in the two studied groups.

	Group I				Group II
	−ve		+ve		−ve		+ve
Wt for age
Range	0.50–97.0		2.90–41.0		3.50–91.0		39.0–78.0
Mean ± SD	31.75 ± 30.53		13.33 ± 11.30		48.08 ± 23.48		61.33 ± 17.99
Median	20.0		12.50		51.0		67.0
p	0.180				0.172
Wt percentiles
<Third percentile	25	28.4	3	25.0	0	0.0	0	0.0
3–97 percentile	63	71.6	9	75.0	93	100.0	6	100.0
FEp	1.000				–
Ht for age
Range	2.90–99.0		2.90–38.0		3.30–86.0		19.0–69.0
Mean ± SD	33.13 ± 28.85		16.58 ± 14.34		40.46 ± 21.72		49.0 ± 23.66
Median	29.0		9.0		40.0		59.0
p	0.107				0.257
Ht percentile
<Third percentile	19	21.6	4	33.3	0	0.0	0	0.0
3–97 percentile	67	76.1	8	66.7	94	100.0	6	100.0
>97	2	2.3	0	0.0	0	0.0	0	0.0
MCp	0.592				-
Wt for Ht
Range	−8.80–2.66		−2.69–0.39		−1.80–2.21		0.26–0.84
Mean ± SD	−0.66 ± 1.74		−1.11 ± 1.06		0.15 ± 0.78		0.47 ± 0.29
Median	−0.37		−0.98		0.24		0.30
p	0.192				0.172
SD
Normal	73	83.0	8	66.7	94	100.0	6	100.0
Abnormal	15	17.0	4	33.3	0	0.0	0	0.0
FEp	0.234				–

Group I: cases with diarrhea Group II: nondiarrheic cases.

Wt: weight Ht: height.

MWp: p value for Mann–Whitney test.

MCp: p value for Monte Carlo test.

FEp: p value for Fisher Exact test.

Table 5 Relation between Cyclospora positive and negative cases and duration of diarrhea in the symptomatic group.

	Cyclospora		Test of significance
	−ve (n = 88)	+ve (n = 12)
Duration of diarrhea
Range	1.0–13.0	1.0–7.0	MWp (p = 0.141)
Mean ± SD	4.52 ± 2.71	3.33 ± 1.67
Median	4.0	3.0

MWp: p value for Mann–Whitney test.

^* Statistically significant at p ⩽ 0.05.

Table 6 Relation between Cyclospora positive and negative cases and clinical presentations in the symptomatic group.

	Cyclospora				Test of significance
	−ve (n = 88)		+ve (n = 12)
	No.	%	No.	%
Vomiting
No	12	13.6	0	0.0	FEp = 0.351
Yes	76	86.4	12	100.0
Fever
No	22	25	5	5.7	FEp = 0.222
Yes	66	75	7	58.3
Dehydration
No	35	39.8	4	33.3	MCp = 0.767
Mild	40	45.4	7	58.3
Severe	13	14.8	1	8.4

FEp: p value for Fisher Exact test.

MCp: p value for Monte Carlo test.

^* Statistically significant at p ⩽ 0.05.