EPIDEMIOLOGY AND TREATMENT OF CYCLOSPORA-CAYETANENSIS INFECTION IN PERUVIAN CHILDREN

Cyclospora cayetanensis was detected in fecal specimens from 63 (1.1%) of 5,836 Peruvian children studied over 2 years; the protozoan was de tected by modified acid-fast staining and autofluorescence under ultra violet light. The highest prevalence occurred among children between 2 and 4 years of age, Thirty-two percent (20) of the 63 C, cayetanensis -infected children were symptomatic, Nineteen infected children were e nrolled in a double-blind, placebo-controlled trial of a 3-day course of trimethoprim-sulfamethoxazole (TMP-SMZ; 5/25 mg/[kg.d]). Children w ere followed up with daily stool examinations (mean number of samples examined per child +/- SE, 19 +/- 4), The mean duration of oocyst excr etion +/- SE was 4.8 +/- 1.2 days for TMP-SMZ recipients compared with 12.1 +/- 6.1 days for placebo recipients (P <.02). The prevalence of C. cayetanensis infection decreases during winter months and as childr en age; it decreases precipitously by adulthood, In children in areas of endemicity, C. cayetanensis usually causes mild disease that is oft en asymptomatic. TMP-SMZ therapy significantly decreases the duration of oocyst excretion.