Cyclospora infection among the school children of Kathmandu, Nepal: prevalence and associated risk factors

Abstract

Background: The intestinal coccidian protozoa Cyclospora cayetanensis has emerged as an important cause of parasitic diarrhea among the children living in developing countries. This study aimed to determine the prevalence of Cyclospora among the school children of Kathmandu with relation to various associated risk factors. Methodology: A total of five hundred and seven stool samples from students between the age group 3-14 years, studying in 13 different schools of Kathmandu were collected during the study period (May- November, 2014) and processed in Public Health Research Laboratory, Institute of Medicine, Kathmandu, Nepal. A modified Acid Fast staining technique (Kinyoun’s method) was used to detect oocyst of Cyclospora from the formal-ether concentrated stool samples. Results: Cyclospora was detected in 3.94% (20/507) of the stool samples examined. The prevalence was found to be highest among the students between the age group 3-5 years i.e. 10.15% (13/128), peaking during the rainy season (June-August). The detection rate of the parasite was found to be significantly higher (p<0.05) among the children presenting with diarrheal symptom, household keeping livestock(s) and consumers of raw vegetables/fruits with prevalence10.57 % (11/104), 10.11% (9/89) and 7.25% (14/193) respectively. Conclusion: Consumption of untreated drinking water, fresh produce (raw fruits/vegetables) without proper washing and livestock presence at home were found to be some of the predisposing factors for higher susceptibility of infection due to Cyclospora. This finding confirms a public-health issue with potentially serious consequences whereby, children can be infected through the exposure to oocyst contaminated food, water and get ill.