Buruli ulcer (BU) caused by Mycobacterium ulcerans (M. ulcerans) is one of the most neglected diseases occurring in Cameroon. BU usually manifests as a skin disease but may also affect the bone. It is prevalent in Cameroon and often found around water stretches, slow flowing rivers, swamps, marshes, lakes, etc. About 500 of the 96,000 people in Akonolinga and Ayos districts in the central province of Cameroon are infected with Buruli ulcer (BU). The infected are mostly children under 15 years of age. Patients with Buruli ulcer suffer from psychological and social hardships; stigma associated with the disease often causes them to be isolated from their families and communities. While the exact mode of transmission remains unknown, person to person transmission is unlikely. A few preventive and therapeutical interventions based on the close resembelance between M. ulcerans and M. tuberculosis are being used but with litte success.

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The emerging protozoan parasites Cryptosporidium, Cyclospora cayetanensis and Isospora belli have altered the etiological spectrum of diarrhea. The progressive decline in CD4 cell count in AIDS patients and lack of active immunity in the face of exposure to contaminated food and water in young children make these groups of persons particularly susceptible to protracted and severe diarrhea caused by the above parasites. Cryptosporidiosis is caused by human as well as several zoonotic species. The present study was undertaken to examine the prevalence of Cryptosporidium species, C. cayetanensis and I .belli among these two susceptible populations in comparison with adult immunocompetent individuals with diarrhea and to identify the Cryptosporidium species prevalent in these populations. A total of 447 children under the age of 5 years, 175 HIV-seropositive adults and 200 HIV seronegative adults with diarrhea attending tertiary care hospitals located in the twin cities of Secunderabad and Hyderabad in South India were included in the study. Single fecal samples were collected. Wet mounts and modified Ziehl Neelsen stained smears made from concentrated fecal specimens were screened microscopically for oocysts of Cryptosporidium, Cyclospora cayetanensis and Isospora belli. DNA extracted from fecal samples positive for Cryptosporidium was subjected to PCR RFLP for species identification. Cryptosporidium was detected in all the three groups, I.e. children (8.7%), HIV-seropositive adults (6.85%), and HIV-seronegative adults (1%). Isospora and Cyclospora were detected only among HIV- seropositive persons at a frequency of 16% and 1% respectively. C. hominis (71.7%) and C. parvum (18.9%) were the only 2 species of Cryptosporidium detected.

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