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CORRESPONDENCE
Year : 2008  |  Volume : 26  |  Issue : 2  |  Page : 203-204
 

Microscopy for cryptosporidiosis screening in remote areas


1 Regional Medical Research Centre, Dibrugarh, India
2 Department of Microbiology, Gauhati Medical College, Guwahati, Assam - 781 005, India

Date of Submission05-Oct-2007
Date of Acceptance23-Nov-2007

Correspondence Address:
P Barua
Regional Medical Research Centre, Dibrugarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.40550

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How to cite this article:
Barua P, Hazarika N K, Barua N, Rasul E, Laskar N. Microscopy for cryptosporidiosis screening in remote areas. Indian J Med Microbiol 2008;26:203-4

How to cite this URL:
Barua P, Hazarika N K, Barua N, Rasul E, Laskar N. Microscopy for cryptosporidiosis screening in remote areas. Indian J Med Microbiol [serial online] 2008 [cited 2019 Sep 15];26:203-4. Available from: http://www.ijmm.org/text.asp?2008/26/2/203/40550


Dear editor,

Cryptosporidium parvum has been responsible for numerous outbreaks of diarrhoeal diseases. [1],[2] In immunocompetent host, the disease is self-limiting but in immunocompromised individual, the disease can become chronic and debilitating. With the increasing number of individuals with HIV/AIDS, cancer patients and malnourished children suffering from diarrhoeal illness, need for an easy, cheap and quick method of diagnosis is required to reduce morbidity. Though ELISA has been widely used as a diagnostic tool, availability of this facility is still poor in peripheral set-up. In this backdrop we wanted to evaluate microscopy vis--vis ELISA in screening stool samples for cryptosporidia in remote areas.

Faecal specimens were collected from immunocompromised ( n = 72) and healthy individuals ( n = 20) attending the outpatient department or in the wards of Medicine, Paediatrics and Haematology of Gauhati Medical College. All the patients had acute or chronic diarrhoeal illness. Specimens were processed by standard protocol [3] while ELISA was performed using the commercially available kit (RIDASCREEN Cryptosporidium R-Biopharm Ag, Darmstadt, Germany).

Cryptosporidium spp. was detected in 11 out of 72 stool specimen by microscopy; while four specimens showed positivity by ELISA. The other parasites isolated are shown in the table. The sensitivity and specificity of ELISA in detection of Cryptosporidial coproantigen was 36.4 and 100% respectively while the negative predictive value (NPV) and positive predictive value (PPV) for the same was 89.7 and 100% respectively.

In our study, we found microscopy more efficacious than performing ELISA in terms of time, equipment and cost for routine diagnosis in remote setup. Modified Z-N staining technique, has been reported to be superior to other diagnostic methods. [4] Our study is in agreement with them and the findings tally with those of Kehl et al. , [5] with respect to superior efficacy of microscopy in respect to ELISA as a procedure for routine diagnosis. The patterns of sensitivity and specificity in our study suggest that microscopy would suffice routine screening of stool specimen for Cryptosporidium spp.

 
 ~ References Top

1.Mackenzie WR, Hoxie NJ, Proctar M. A massive outbreak in Milwaukee of cryptosporidium infection transmitted through the public water supply. N Engl J Med 1994;331:161-7.  Back to cited text no. 1    
2.Millard P, Gensheimer K, Addiss D. An out break of cryptosporidiosis from fresh-pressed apple cedar. J Am Med Assoc 1994;272:1592-6.  Back to cited text no. 2    
3.Forbes BA, Sahm DF, Weissfeld AS. Diagnostic Microbiology: 10 th ed. Mosby: 1998. p. 859-63.  Back to cited text no. 3    
4.Henricksen S, Pohlenz JF. Staining of Cryptosporidia by a modified Ziehl Neelsen technique. Acta Vet Scand 1981;22:594-6.  Back to cited text no. 4    
5.Kehl KS, Cicirello H, Havens PL. Comparison of four different methods for the detection of Cryptosporidium species. J Clin Microbiol 1995;33:416-8.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]



 
 
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