Cryptosporidium, enterocytozoon, and cyclospora infections in pediatric and adult patients with diarrhea in Tanzania

Cryptosporidiosis, microsporidiosis, and cyclosporiasis were studied in fou r groups of Tanzanian inpatients: adults with AIDS-associated diarrhea, chi ldren with chronic diarrhea (of whom 23 of 59 were positive [(+)] for human immunodeficiency virus [HIV]), children with acute diarrhea (of whom 15 of 55 were HIV+), and HIV- control children without diarrhea, Cryptosporidium was identified in specimens from 6/86 adults, 5/59 children with chronic d iarrhea (3/5, HIV+), 7/55 children with acute diarrhea (0/7, HIV+), and 0/2 0 control children. Among children with acute diarrhea, 7/7 with cryptospor idiosis were malnourished, compared with 10/48 without cryptosporidiosis (P < .01). Enterocytozoon was identified in specimens from 3/86 adults, 2/59 children with chronic diarrhea (1 HIV+), 0/55 children with acute diarrhea, and 4/20 control children. All four controls were underweight (P < .01), C yclospora was identified in specimens from one adult and one child with acu te diarrhea (HIV-). Thus, Cryptosporidium was the most frequent and Cyclosp ora the least frequent pathogen identified. Cryptosporidium and Enterocytoz oon were associated with malnutrition. Asymptomatic fecal shedding of Enter ocytozoon in otherwise healthy, HIV- children has not been described previo usly.