This study investigated the prevalence of intestinal protozoal parasites in stool samples from 249 children aged 0-5 years presenting with diarrhea at a hospital in KwaZulu-Natal, South Africa. The researchers found Cryptosporidium parvum in 20% of samples and Giardia lambliae in 3% of samples using staining techniques to examine the stool under a microscope. Cryptosporidium parvum was found to have a higher prevalence than Giardia lambliae. The results correlated with other African studies showing Cryptosporidium parvum prevalence between 20-30%, while the lower detection of Giardia lambliae was consistent with other African studies but lower than previous local studies

1. UKZN INSPIRING
Intestinal protozoal parasites in
children aged 0-5 years presenting
with diarrhoea in the eThekwini
district of KwaZulu-Natal
Mathaparsadh, N. , Kwitshana, Z.L., Ashiru, O.T., Sturm, A.W.
and Moodley, P.
School of Laboratory Medicine and Medical Sciences

2. Diarrhoea
• Major cause of morbidity and
mortality
1,9 million deaths p.a. in the 0-5 age group
78% occur in Africa and South-East Asia
• Risk factors
living in rural areas
no access to clean water
improper sanitation
malnutrition
lack of hygiene

3. • Intestinal parasitic infections are
common globally
• Accounting for 3.5 billion infections
 majority children

4. • Intestinal protozoal parasites
Entamoeba histolytica
Giardia lambliae
Cryptosporidium parvum
Cyclospora cayetanensis
Microsporidia spp.
Isospora belli
Dientamoeba fragilis
Balantidium coli
Blastocystis hominis

5. Aim
• To determine and identify the
prevalence of protozoal parasites
in stool specimens of children ≤5
years of age, presenting at King
Edward VIII Hospital, Durban

6. Methodology
• Ethics approval
Ethics no. BE222/13
• Informed consent obtained
• Stool specimens from 249 patients
 preserved (5% formalin)
detection of protozoa

7. Microscopic analyses
• Smears prepared and stained with:
 modified Ryan-Blue Trichrome stain
 modified Ziehl-Neelsen stain
• Viewed under light microscopy
scan at 450 x
confirmation at 1000 x

8. Results
The prevalence of intestinal parasites stratified by
staining technique in children ≤ 5 years (n=249)
Technique No. (%) Detected
G. lambliae C. parvum NPS
Ziehl-Neelsen stain 2 (1) 36 (15) 209(84)
Trichrome stain 6 (3) 18 (7) 224(90)
Total no. of positive 6 (3) 50 (20)
patients
*NPS – No Protozoal Parasite Seen
**G. lambliae stained blue in the ZN Stain

11. Discussion
• C. parvum prevalence
correlates well with similar
studies in Africa
 20 - 30% prevalence
• C. parvum higher prevalence
than G. lamblia
 13% of study participants HIV positive
17% of study participants exposed to HIV

12. • G. lamblia discordant with previous
studies in KZN
 23 – 75% prevalence (Kwitshana, 1999)
• But concordant with studies in
Africa
3 – 13 % prevalence

13. Limitations
• single stool specimen collected
• stool collected from diapers which
has urine
dilutes the positive sample
prevents trophozoite motility
• stool specimens not always
preserved within the 2hr
recommended time-frame
• stool specimens could not be
viewed immediately

14. Conclusion
• In our study:
 2 protozoal parasites prevalent
 Giardia lambliae and Cryptosporidium parvum
 of these parasites C. parvum demonstrated a
higher prevalence than G. lambliae

15. Acknowledgements
• Patients
• Clinical staff
• Research nurses
• Laboratory staff and fellow students
• KZN DOH
• CHS
• NRF

16. Thank you