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Cryptosporidiosis: Symptoms, Causes, Treatment, and More

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Cryptosporidiosis: Symptoms, Causes, Treatment, and More

The type species of the genus Cryptosporidium described by Tyzzer 1907 is C.muris, from the gastric glands of laboratory mice. C. felis in cats (Iseki 1979), C.
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Cryptosporidiosis is caused by protozoan parasites of the genus Cryptosporidium (family Cryptosporidiidae, order Eucoccidiorida, subclass Coccidiasina, class Sporozoasida, subphylum Cryptosporidiosis is caused by protozoan parasites of the genus Cryptosporidium (family Cryptosporidiidae, order Eucoccidiorida, subclass Coccidiasina, class Sporozoasida, subphylum Apicomplexa). Cryptosporidium are sm

all intracellular parasites, which occur throughout the animal kingdom and have been reported in many species of mammals, birds, reptiles, amphibians and fish. A more complete description of the life cycle was published (Tyzzer, 1910) and subsequently a second species, C. parvum, was also described from laboratory mice (Tyzzer, 1912). parvum differed from the type species, not only by infecting the small intestine rather than the stomach, but also because the oocysts were smaller. Following the initial discovery of Cryptosporidium, over 50 years passed during which the parasite was commonly confused with other Apicomplexa parasites, especially members of the coccidian genus Sarcocystis. The reason for this was that many Sarcocystis spp. have oocysts with thin walls that often rupture, releasing free sporocysts, and because each sporocyst contains four sporozoites like Cryptosporidium oocysts, a variety of named and unnamed species were erroneously assigned to the genus. Subsequent ultra structural studies, however, supported earlier light microscopy studies and showed that Cryptosporidium species possessed a unique attachment organelle (Hampton and Rosario, 1966), which is the key feature that currently defines the genus and family (Levine, 1985). More than 20 'species' of Cryptosporidium parasite have been described on the basis of the animal hosts from which they were isolated, however, the lack of host specificity with many species has brought into question the validity of many species classified in this way. For a while, limited transmission studies were used as evidence for the mono-specific nature of the genus Cryptosporidium, resulting in the widespread use of the name C. parvum for Cryptosporidium parasites from all kinds of mammals, including humans. Other Cryptosporidium parasites, such as C. meleagridis in turkeys (Slavin 1955), C. wrairi in guineapigs (Vetterling et al., 1971), C. baileyi in birds (Current et al., 1986) and C. saurophilum in lizards (Koudela and Modry, 1998), were however, considered to be separate species based on demonstrated biological differences from the established species C parvum and C. muris. In recent years, molecular characterizations of Cryptosporidium have helped to clarify the confusion in Cryptosporidium taxonomy and validate the existence of multiple species in each vertebrate class. As a consequence, the complete taxonomy of the genus has undergone major revision based on a number of parameters that included not only morphology but also developmental biology, host specificity, histopathology, and sequence-based differences, within the ribosomal RNA (rRNA) gene repeat unit between individual isolates within a previously ‘valid’ species. Species definition and identification of this genus is therefore constantly changing, with the addition of new species based primarily on molecular criteria. Currently there are 13 valid species namely: C. hominis found primarily in humans (previously known as C. parvum Type 1), C. parvum, found in humans and other mammals (previously known as C. parvum Type 2), C. andersoni in cattle, C. canis in dogs, C. muris in mice, C. felis in cats, C. wrairi in guineapigs, C. meleagridis in turkeys and humans, C. baileyi in chickens, C. galli in finches and chickens, C. saurophilum in lizards, C. serpentis in snakes and lizards, and C. molnari in fish (Xiao et al., 2004). Cryptosporidium species infect the microvillus border of the gastrointestinal epithelium of a wide range of vertebrate hosts, including humans (see Table 1). Infected individuals show a wide spectrum of clinical presentations, but the pathogenicity of Cryptosporidium varies with the species of parasites involved and the type, age, and immune status of the host. In many animals, Cryptosporidium infections are not associated with clinical signs or are associated with only acute, self-limiting illness. In some animals, such as reptiles infected with Cryptosporidium serpentis or individuals who are immunosuppressed, the infection is frequently chronic and can eventually be lethal.

02/12/2022

Preventing the infection
The best way to avoid being infected with Crypto and contributing to its spread is to practice good hygieneTrusted Source. Teach children good hygiene habits while they’re young.

The CDC recommends you scrub your hands with soap and water for at least 20 seconds in the following cases:

after using the bathroom, changing a diaper, or helping others use the bathroom
before eating or cooking
after handling an animal
after gardening, even if you used gloves
when caring for someone with diarrhea
The CDC also recommends these other tips for preventing Crypto infection:

Stay home or keep young children home when you or they have an active case of diarrhea.
Don’t drink unfiltered water.
Shower before using recreational swimming facilities to wash away any potential Cryptosporidium organisms on your body.
Don’t swallow pool water.
Wash all produce before eating it. Peeling the skins will also reduce your risk.
Take young children at the pool to the bathroom frequently.
Change children’s diapers often.
Stay clear of the water if you or your children have diarrhea. Stay out of the water for a full two weeks after the diarrhea subsides.

02/12/2022

Symptoms of cryptosporidiosis
The telltale symptoms of Crypto include:

frequent and watery diarrhea
nausea
vomiting
stomach cramps
fever
Symptoms generally begin within a week of exposure and can last two weeks. However, in one study published in BMC Public HealthTrusted Source, some people had symptoms that persisted 24 to 36 months.

With long-term symptoms, a person is at increased risk of weight loss, dehydration, and malnutrition. This can be particularly life-threatening in young babies and people with weakened immune systems, such as those who have HIV or who are undergoing chemotherapy. There are several parasitic infections that can have similar or different symptoms.

02/12/2022

Causes of cryptosporidiosis
A person can develop Crypto after coming in contact with contaminated f***s. This exposure often happens by swallowing recreational swimming water. Anywhere people congregate in water — swimming pools, water parks, hot tubs, lakes, and even the ocean — can contain Cryptosporidium. Other serious infections can also be contracted in these environments.
According to the National Foundation for Infectious Diseases, Cryptosporidium germs are a leading cause of waterborne disease in this country. Young children who often splash and play in water are susceptible to the infection, which peaks in prime swimming season in the summer and fall.
Source reports that millions of Cryptosporidium parasites can be shed in the bowel movement of just one infected person, making Crypto highly contagious. And because the parasite is surrounded by an outer shell, it’s resistant to chlorine and other disinfectants. The parasite can live for days, even in pools properly treated with chemicals.
Crypto germs can also be spread through hand-to-mouth contact. They can be found on any surface that’s been contaminated with infected f***s. Because of this, the infection can also be transmitted by:
playing with contaminated toys
touching bathroom surfaces without properly washing your hands
handling animals
having s*x
drinking untreated water
touching dirty diapers
handling unwashed produce grown in contaminated soil

16/12/2021

Cryptosporidiosis is an infection that typically leads to diarrhea. Learn the causes and symptoms of cryptosporidiosis, including the life cycle of cryptosporidium, the parasite responsible for cryptosporidiosis. Review how infection occurs and explore prevention methods, diagnosis, and treatment. Updated: 08/31/2021
Waterborne Illness in Milwaukee
In April 1993, the emergency rooms in Milwaukee, Wisconsin, were flooded with people all exhibiting the same symptoms: mild fever, stomach cramps, and watery diarrhea. Over 4,000 people sought medical help, with 69 of those dying from the mystery illness. This was just the tip of the iceberg. More than 400,000 people showed some variation of the same symptoms, with the only other common thread being that they all were served by the same water treatment facility. Experts determined that spring rains combined with snow melt runoff had overwhelmed the filters at the treatment plant, resulting in billions of parasites being released into the drinking water. The name of the parasite responsible for the largest outbreak of a waterborne infection in United States history is Cryptosporidium parvum.

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Cryptosporidium
Cryptosporidium, or Crypto for short, is a protozoan parasite that infects the gastrointestinal lining of most vertebrates. There are many individual species of Crypto that infect specific host species. The two species that usually cause disease in humans are C. parvum and C. hominis. In the United States alone, there are an estimated 748,000 cases of cryptosporidiosis every year.

Life Cycle
Let's take a closer look at the life cycle of Cryptosporidium. Infection begins with the ingestion of an oocyst, which houses the immature, developing parasite zygote. The oocysts have thick walls and are very resistant to environmental stress, allowing the parasite to survive outside of the host.

Once in the digestive tract, the oocyst will excyst and release sporozoites into the stomach or small intestine. A sporozoite is the cell stage capable of infecting a new host. Crypto is an intracellular parasite, meaning it lives inside cells, so the sporozoites invade the cells of the stomach and intestinal lining.

Inside the host cell, the sporozoite matures into a trophozoite. This is the mature, feeding stage of the parasite. The trophozoites first reproduce as*xually inside the cell. These parasite clones then burst from the host cell and begin reproducing s*xually. Two types of oocysts result from the s*xual reproduction: thick-walled and thin-walled.

The thin-walled oocysts remain in the host and reinfect another epithelial cell. The thick-walled oocysts are excreted in the f***s and can infect a new host. These oocysts are shed in very high numbers, often in the millions.

There is also some evidence that Crypto can infect the respiratory tract as well. Inhaled oocysts can invade the lining of the lungs and complete their lifecycle, with infectious oocysts exhaled back into the environment.

Infection and Prevention
We started the lifecycle description by ingesting an oocyst. But where did that oocyst come from? Humans acquire Cryptosporidium by the f***l-oral route, usually by drinking water contaminated with f***s. Officials suspect that the outbreak in Milwaukee occurred because the heavy runoff that overwhelmed the treatment plant was contaminated with farm runoff. Cattle, especially young calves, are notorious for shedding Crypto oocysts.

Accidental swallowing of contaminated recreational waters from pools and lakes is a major contributor to the spread of Cryptosporidium. Normal chemical sterilization techniques have absolutely no effect on the oocysts. Cryptosporidium is particularly resistant to chlorine and is able to survive for several hours in undiluted chlorine bleach.

Also, since the spread of Crypto is f***l-oral, daycare centers are an outbreak hotspot due to the close quarters and absence of hygiene awareness in young children. Any infected individual can contaminate surfaces with oocysts, creating sources of new infections.

The best methods of preventing Crypto infection involve sedimentation and filtration of water. The oocysts will settle out of solution, sort of like the snowflakes falling to the bottom of a snow globe. Water taken from the surface should be clear and the sunken oocysts can be easily removed from the bottom of the tank. One-micron water filters are also effective at removing oocysts. For campers, boiling water will kill all oocysts, but this is not a viable solution in large-scale municipal water treatment.

Proper hygiene is usually enough to prevent infection from f***l contamination. Regular hand-washing and bathing will strip most oocysts from people's bodies. Surface disinfection can be a bit trickier. I already mentioned that bleach is ineffective. Most commercial cleaners won't kill the oocysts regardless of contact time. The most effective surface treatment is 3% hydrogen peroxide for at least 20 minutes. This won't kill all the oocysts, but it should reduce the number to a less dangerous amount. Ammonia is also somewhat effective, but the risks of working with this toxic chemical probably outweigh

16/12/2021

Cryptosporidium is a microscopic parasite that causes the diarrheal disease cryptosporidiosis. Both the parasite and the disease are commonly known as “Crypto.”

There are many species of Cryptosporidium that infect animals, some of which also infect humans. The parasite is protected by an outer shell that allows it to survive outside the body for long periods of time and makes it very tolerant to chlorine disinfection.

While this parasite can be spread in several different ways, water (drinking water and recreational water) is the most common way to spread the parasite. Cryptosporidium is a leading cause of waterborne disease among humans in the United States.

16/12/2021

What is cryptosporidiosis?
Cryptosporidiosis is an infection that causes diarrhea. It is sometimes called Crypto. It is caused by a parasite found in stool. You can get this infection after eating food or drinking water that is contaminated with stool. This includes swallowing water while swimming. You can also get infected if you touch things or surfaces contaminated with stool. You can also get the infection from another person.

The parasite has an outer shell. Because of this, using chlorine to clean water may not kill the parasite. Crypto is one of the most common causes of waterborne disease in the U.S.

What causes cryptosporidiosis?
Cryptosporidiosis is caused by the parasite Cryptosporidium. Once inside your body, the parasite passes through your digestive tract and infects your stool. Anything contaminated with the infected stool can pass the infection on to other people.

Who is at risk for cryptosporidiosis?
The parasite is found throughout the world. But you are more likely to get the infection if you travel to rural areas in developing countries. Or if you often eat or drink in areas where sanitation is poor. Outbreaks have also occurred in the U.S. when water supplies or swimming pools become infected.

The disease is spread by accidentally swallowing anything that has come into contact with the stool of a person or animal with the infection. This includes:

Swallowing water contaminated with the parasite. The parasite can be found in swimming pools, hot tubs, jacuzzis, lakes, rivers, springs, ponds, or streams contaminated with sewage or stool.
Eating uncooked foods tainted with the parasite.
Swallowing the parasite picked up from surfaces contaminated with the stool of an infected person. This includes bathroom fixtures, changing tables, and diaper pails.
Cryptosporidiosis is normally not a serious disease in healthy people. But it can lead to a life-threatening illness for people with a weak immune system. Those at risk are:

People with HIV/AIDS
Cancer and transplant patients who are taking certain medicines that suppress the immune system
People with inherited diseases that affect the immune system
What are the symptoms of cryptosporidiosis?
Each person may have slightly different symptoms. These are the most common symptoms:

Diarrhea
Loose or watery stools
Vomiting
Weight loss
Stomach cramps
Fever
You may not have any symptoms. If symptoms do develop, they often last about 2 weeks and sometimes longer. But even if you have no symptoms, the parasite is passed in your stool for up to 2 months. During this time you are at risk of spreading the infection to others.

How is cryptosporidiosis diagnosed?
Your healthcare provider will look at a stool sample. Sometimes multiple stool samples (usually 3) will be needed since this parasite is found only intermittently in the stool. You will need special testing because tests for this disease are not routinely done in labs.
How is cryptosporidiosis treated?
Most people with a healthy immune system do not need to be treated as cryptosporidiosis will resolve on its own. In those who have weak immune systems, the focus of treatment is often on getting the immunity back. Otherwise, a medicine called nitazoxanide can be used to treat this parasite.

Your healthcare provider will figure out the best treatment for you based on:

How old you are
Your overall health and past health
How sick you are
How well you can handle specific medicines, procedures, or therapies
How long the condition is expected to last
Your opinion or preference
No treatment works fully against the infection. If you have a healthy immune system, you will likely recover on your own. People who are in poor health or have a weak immune system may get a more serious infection. In some cases, you may need to take medicine for diarrhea. It’s important to drink plenty of fluids to stay hydrated.

Can cryptosporidiosis be prevented?
There is no vaccine to prevent cryptosporidiosis. The best way to protect yourself is with good personal hygiene. Also:

Wash your hands thoroughly with soap and water after using the toilet or changing diapers.
Wash your hands thoroughly before eating or making food.
Wash and peel all raw fruits and vegetables before eating.
Don't drink water from lakes, rivers, springs, ponds, or streams, unless they have been filtered and chemically treated.
Don't drink any water or eat any food that may be tainted.
When traveling to countries where the water supply may be unsafe, do not drink unboiled tap water. Also do not eat any raw foods washed with tap water. Choose steaming hot drinks, such as coffee and tea, and pasteurized fruit drinks. Make sure bottled water is safe to drink.
Many home water filters can remove Cryptosporidium. Read the label for details.
When should I call my healthcare provider?
Call your healthcare provider right away if your symptoms return or get worse, or you have new ones.

Key points
Cryptosporidiosis is an infection that causes diarrhea. It is caused by a parasite.
Most people get the parasite after swallowing food or water tainted with stool. This includes swallowing water while swimming.
Diarrhea, vomiting, and weight loss are the most common symptoms.
Dehydration is the main complication.
Good personal hygiene can help prevent it. You should also stay away from unclean water sources.
Next steps
Tips to help you get the most from a visit to your healthcare provider:

Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your provider if you have questions.

17/09/2021

The most common symptom of cryptosporidiosis is watery diarrhea. Other symptoms include:

Stomach cramps or pain
Dehydration
Nausea
Vomiting
Fever
Weight loss
Some people with Crypto will have no symptoms at all. While the small intestine is the site most commonly affected, Crypto infections could possibly affect other areas of the digestive tract or the respiratory tract.

How long after infection do symptoms appear?
Symptoms of cryptosporidiosis generally begin 2 to 10 days (average 7 days) after becoming infected with the parasite.

How long will symptoms last?
In persons with healthy immune systems, symptoms usually last about 1 to 2 weeks. The symptoms may go in cycles in which you may seem to get better for a few days, then feel worse again before the illness ends.

Who is most at risk for cryptosporidiosis?
People who are most likely to become infected with Cryptosporidium include:

Children who attend day care centers, including diaper-aged children
Child care workers
Parents of infected children
People who take care of other people with cryptosporidiosis
International travelers
Backpackers, hikers, and campers who drink unfiltered, untreated water
People who drink from untreated shallow, unprotected wells
People, including swimmers, who swallow water from contaminated sources
People who handle infected cattle
People exposed to human f***s through s*xual contact
Contaminated water may include water that has not been boiled or filtered, as well as contaminated recreational water sources (e.g., swimming pools, lakes, rivers, ponds, and streams). Several community-wide outbreaks of cryptosporidiosis have been linked to drinking municipal water or recreational water contaminated with Cryptosporidium.

17/09/2021

Cryptosporidiosis is a diarrheal disease caused by microscopic parasites, Cryptosporidium, that can live in the intestine of humans and animals and is passed in the stool of an infected person or animal. Both the disease and the parasite are commonly known as "Crypto." The parasite is protected by an outer shell that allows it to survive outside the body for long periods of time and makes it very resistant to chlorine-based disinfectants. During the past 2 decades, Crypto has become recognized as one of the most common causes of waterborne disease (recreational water and drinking water) in humans in the United States. The parasite is found in every region of the United States and throughout the world.

How is cryptosporidiosis spread?
Cryptosporidium lives in the intestine of infected humans or animals. An infected person or animal sheds Crypto parasites in the stool. Millions of Crypto germs can be released in a bowel movement from an infected human or animal. Shedding of Crypto in the stool begins when the symptoms begin and can last for weeks after the symptoms (e.g., diarrhea) stop. You can become infected after accidentally swallowing the parasite. Cryptosporidium may be found in soil, food, water, or surfaces that have been contaminated with the f***s from infected humans or animals. Crypto is not spread by contact with blood.

Crypto can be spread:

By putting something in your mouth or accidentally swallowing something that has come into contact with stool of a person or animal infected with Crypto.
By swallowing recreational water contaminated with Crypto. Recreational water is water in swimming pools, hot tubs, Jacuzzis, fountains, lakes, rivers, springs, ponds, or streams. Recreational water can be contaminated with sewage or f***s from humans or animals.
By swallowing water or beverages contaminated with stool from infected humans or animals.
By eating uncooked food contaminated with Crypto. Thoroughly wash with uncontaminated water all vegetables and fruits you plan to eat raw. See below for information on making water safe.
By touching your mouth with contaminated hands. Hands can become contaminated through a variety of activities, such as touching surfaces (e.g., toys, bathroom fixtures, changing tables, diaper pails) that have been contaminated by stool from an infected person, changing diapers, caring for an infected person, changing diapers, caring for an infected person, and handling an infected cow or calf.
By exposure to human f***s through s*xual contact.
Cryptosporidiosis Symptoms and Signs
Nausea and Vomiting
Nausea and vomiting are symptoms of an underlying illness and not a specific disease. Nausea is the sensation that the stomach wants to empty itself, while vomiting (emesis) or throwing up, is the act of forcible emptying of the stomach. The term "dry heaves" refers to an episode of vomiting where there is no food in the stomach to vomit, and only clear secretions are vomited.

Vomiting is a violent act in which the stomach almost turns itself inside out - forcing itself into the lower portion of the esophagus (the tube that connects the mouth to the stomach) during a vomiting episode, expelling food and secretions.

17/09/2021

Cryptosporidiosis is a diarrheal disease caused by parasites named Cryptosporidium; the parasites have a life cycle that can be completed in humans and many types of animals.
The disease cryptosporidiosis is spread from person to person after the parasites are shed into the environment; they may be found in soil, food, water, or on surfaces that have been contaminated with f***s from infected humans or animals.
Symptoms of cryptosporidiosis include
watery diarrhea,
stomach cramps or pain,
dehydration,
nausea,
vomiting,
fever,
weight loss,
lack of appetite.
Some individuals will have no symptoms at all.
Symptoms usually begin two to 10 days after becoming infected.
Symptoms last about one to two weeks. The symptoms may go in cycles -- someone may seem to get better for a few days and feel worse for a few days before the infection ends.
People at most risk for this disease are children in day-care centers, child-care workers, parents with infected children, international travelers, backpackers, hikers and campers who drink unfiltered or untreated water, swimmers who swallow water from contaminated sources, people exposed to human f***s during s*xual contact, and individuals who handle infected cattle.
Those at risk for serious illness are individuals with a severely weakened immune system; young children and pregnant women may be more susceptible to dehydration.
Individuals suspecting cryptosporidiosis infection should see their primary-care physician.
Testing usually requires submission of several stool specimens over several days; tests for cryptosporidiosis are not routinely done in most laboratories so the results will require sending specimens out to a special lab.
Although some patients can self-cure without medication, treatment for this disease is the prescription drug nitazoxanide (Alinia); other treatment includes hydration and possibly antidiarrheal medication. Immunodepressed patients may have difficulty clearing this infection.
People diagnosed with cryptosporidiosis are very contagious and need to practice good hygiene with soap and water, avoid swimming in recreational water such as pools, hot tubs, rivers, and lakes (for at least two weeks after the diarrhea stops), avoid s*xual practices that might result in oral exposure to stool, avoid close contact with immunosuppressed individuals, and children with cryptosporidiosis diarrhea should be excluded from child-care settings until the diarrhea has stopped.

17/09/2021

Out of the 112 children of ages 0–5 years with and without diarrhea recruited in this study, 10 were positive for cryptosporidiosis giving a prevalence of 8.93%. This result is less than the result obtained in Tanzania and Ethiopia [23, 24] with 10.4 and 9.4% respectively. High prevalence has also, been found in countries with high average rainfall such as Nigeria [25], 38.3%. This low prevalence is probably justified by fact that Limbe is a city with improved access to drinkable water, latrine use, less floods and good city drainage system which reduces f***l contamination rates, thus limiting occurrence of parasitosis in general and cryptosporidiosis in particular. Also, this low prevalence may be explained by methodology, using microscopy which can be less sensitive than PCR.

The prevalence amongst those that were presenting with diarrhea was 9 (13.40%).This prevalence (13.40%) is higher than the prevalence obtained in a study carried out in Rwanda (7.2%) [26], this may be due to the fact that this study was conducted mainly in the rainy season which was characterized by average rainfall, a period thus favoring the multiplication of oocysts. This prevalence (13.40%) was slightly lower than the prevalence of 16.3% obtained in Tanzania [24], where cryptosporidium was predominance in the rainy season and the rain cause the spread of f***l matter that contaminates drinkable water, fruit and vegetables. Also, a study carried out in Bangui, [27] among children within the ages 0–5 years was partially in line with a prevalence of Cases- 42/333 (12.6%) Controls- 9/333 (2.7%). This distribution of cryptosporidium oocyst with regards to gender, was slightly greater in females 6 (5.36%) than in males 4 (3.57%), but there was no significant difference (p = 0.942). The reason for these difference is not clear since they have the same exposure at crawling stage but may be probably due to the fact that the female constitute majority of the population in the study.

The prevalence of cryptosporidiosis with respect to age was not statistically significant even though prevalence 6 (5.36%) of cryptosporidiosis was obtained in the children between the age group 00–30 months old. This result is in line with a study carried out in Berlin, Germany [28] and by CDC in 2017 [29] where a higher prevalence was obtained among children of ages 00–30 months than those above 30 months. This high prevalence in this age is probably due to the fact that this age group are more vulnerable to diarrhea because basic hygiene rules are neither known nor respected and couple with the fact that the immune system is not well developed [29].

This high proportion of children with ages 0–3 years also explains why very few children in our study attended school, because the age of schooling in Cameroon is generally around 3 years. Also, this prevalence in this age group (0–5 years) can be attributed to the fact that the peak of parasitism occurs at the age at which children are sent to kindergarten and primary schools when community games and contact with dirty soil favour contamination. In addition, the rate of malnourished children in this study population 0 (00%) is lower than the rate found at the national level, which was 36% for children less than 5 years [30]. This may be due to the fact that this study was carried out in Limbe an urban area with a cosmopolitan population, where children are better fed than in rural areas where malnutrition rates may be higher. Children that never had exclusive breastfeeding within the first 6 months of life showed greater prevalence 8 (7.14%) of Cryptosporidiosis (p = 0.022) than in children who had exclusive breast feeding 2 (1.79%). This is probably due to the fact that most mothers, mostly the elderly in our settings consider the idea of exclusive breastfeeding as ordinary fluid from the mammary gland not being enough as a meal for an infant. Also, believing that these infants do get thirsty and require water to “quench” their thirst. Traditional force-feeding practices by forcing through oral drenching using bare hands to ensure that the children take in enough food for proper growth [31]. The risk of using bare hands (which in most cases might not be properly washed) for feeding babies may enable the transmission of food borne disease like Cryptosporidiosis from infected adult to infants. These practices generate opportunities for the ingestion of food and water contaminated with Cryptosporidium oocysts shed from infected individuals. This elaborates why Cryptosporidium is ranked 5th among the most important food borne parasites globally [31, 32].

Moreover, in most developing countries like Cameroon, cryptosporidium infection is common among toddler’s/younger hosts because they are more vulnerable to Cryptosporidium infection and it is speculated breastfeeding offers some form of protection, which may be through mother-child immunoglobulin response coupled with not using contaminated water [32]. This may explain why Cryptosporidium infection is mostly delayed till 6 months and beyond when complementary foods are introduced. However, the infection is common in children but tends to decrease with increasing age which suggests the development of immunity from frequent exposure to infective agents in the environment.

High prevalence 8 (7.14%) was seen in children who drank municipal water from tap(p = 0.018) than in children who drank commercial bottled water and municipal water processed at home by filter 1 (0.89%). This may be due to the fact that Cryptosporidium oocysts can resist chlorine treatment in water for months. Since the local population trust pipe borne water, it is rare to see them boil pipe borne water for the purpose of drinking. According to Medema and Schijven [25], oocysts are resistant and survive for 180 days in water and up to 1 year at 4 °C. Meanwhile, the treatment and cleaning of water treatment plants in our communities are hardly regular which could be a predisposing factor. Children 0-3 years will usually take water from unknown source and at times in dirty cups and drink. A high prevalence 8 (80%) was seen in children whose parents’ educational level was primary school. This is consistence with understanding the mode of transmission of the infection and the importance of implementing proper hygiene and sanitation practices. Majority of these parents with primary level of education turn to mostly ignore or neglect the implementation of good hygiene practices saying “black man no di die dirty”. The limitations of diagnosis of cryptosporidium based only on microscopy can underestimate or overestimate the prevalence. Since we used just microscopy due to lack of advanced methods like ELISA and PCR, our comparison of prevalence was done only with studies that used the same methodology.

Conclusion
An overall prevalence rate of Cryptosporidium among children within the ages 0–5 years that attended the Limbe Regional Hospital was 8.93%. Prevalence among children that presented with diarrhea was 13.4%. Children from parents with primary level of education, children whose parents did not respect exclusive breastfeeding and those children whose parents were giving them pipe borne water for drinking recorded a higher prevalence. Also, there is a significant association between Cryptosporidium and diarrhea among children of ages 0–5 years presenting with diarrhea in Limbe. The results clearly demonstrated that Cryptosporidium is an important protozoal etiologic agent for children with diarrhea in Limbe.

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