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Molecules 2014, 19(2), 2674-2683; doi:10.3390/molecules19022674
Article

Comparative Diagnostic Techniques for Cryptosporidium Infection

1
, 1,* , 2
 and 3
Received: 25 December 2013; in revised form: 20 January 2014 / Accepted: 21 January 2014 / Published: 24 February 2014
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Abstract: Diarrhoea caused by Cryptosporidium is usually mild in immune competent individuals but severe in the young and those with underlying disease leading to compromised immunity. The conventional diagnosis of Cryptosporidium requires observation of the infective oocysts however, their tiny size yields indistinct results, thus limiting the effectiveness of the conventional diagnostic technique, modified Ziehl-Neelsen (ZN) differential staining. Consequent to the abovementioned limitation, ZN staining, sandwich antigen detection enzyme linked immunosorbent assay (sad-ELISA) and a direct polymerase chain reaction (PCR) assay techniques were evaluated for diagnostic efficacy. Stool samples were collected from 180 consenting adult patients attending outpatient and inpatient clinics at Victoria Hospital, Alice, Eastern Cape Province of South Africa. Subjects were stratified as; 35 HIV-positive and diarrhoeagenic, 125 HIV-negative diarrhoeagenic and 20 apparently healthy controls. Cryptosporidium incidence following diagnostic techniques were 13 (37.1%; ZN staining), 26 (74.3%; sad-ELISA) and 23 (65.7%; PCR), respectively, among HIV-positive diarrhoeagenic patients and 34 (27.2%; ZN staining), 96 (76.8%; sad-ELISA) and 89 (71.2%; PCR) among HIV-negative diarrhoeagenic patients. Sensitivity, specificity and predictive values of the diagnostic techniques’ efficiency were: sensitivity: 46.2% (HIV-positive) and 32.3% (HIV-negative) against the ZN technique and 96.9% against sad-ELISA and PCR, respectively, for both HIV-positive and -negative patients; specificity was 88.9% (HIV-positive) and 96.6% (HIV-negative) against the ZN technique. Lastly, the predictive values were 92.3% (HIV-positive) and 96.9% (HIV-negative), respectively, following ZN staining. The sad-ELISA technique proved more suitable for the determination of the presence of Cryptosporidium oocysts. The high incidence of Cryptosporidium in HIV-positive subjects as compared to the HIV-negative population accentuates the significance of cryptosporidiosis diagnosis in the treatment and management of HIV cases.
Keywords: cryptosporidiosis; Cryptosporidium species; staining techniques; antigen detection ELISA; PCR cryptosporidiosis; Cryptosporidium species; staining techniques; antigen detection ELISA; PCR
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Omoruyi, B.E.; Nwodo, U.U.; Udem, C.S.; Okonkwo, F.O. Comparative Diagnostic Techniques for Cryptosporidium Infection. Molecules 2014, 19, 2674-2683.

AMA Style

Omoruyi BE, Nwodo UU, Udem CS, Okonkwo FO. Comparative Diagnostic Techniques for Cryptosporidium Infection. Molecules. 2014; 19(2):2674-2683.

Chicago/Turabian Style

Omoruyi, Beauty E.; Nwodo, Uchechukwu U.; Udem, Chukwuneke S.; Okonkwo, Francis O. 2014. "Comparative Diagnostic Techniques for Cryptosporidium Infection." Molecules 19, no. 2: 2674-2683.


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