Cryptosporidium Infections in Africa-How Important Is Zoonotic Transmission? A Review of the Evidence.

Autor:	Robertson LJ; Parasitology Laboratory, Department of Paraclinical Science, Faculty of Veterinary Medicine Norwegian University of Life Sciences, Oslo, Norway., Johansen ØH; Department of Clinical Science, University of Bergen, Bergen, Norway.; Department of Microbiology, Vestfold Hospital Trust, Tønsberg, Norway., Kifleyohannes T; Parasitology Laboratory, Department of Paraclinical Science, Faculty of Veterinary Medicine Norwegian University of Life Sciences, Oslo, Norway.; Department of Veterinary Basic and Diagnostic Sciences, College of Veterinary Medicine, Mekelle University, Mekelle, Ethiopia., Efunshile AM; Department of Medical Microbiology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria.; Department of Medical Microbiology, Ebonyi State University, Abakaliki, Nigeria., Terefe G; College of Veterinary Medicine and Agriculture, Department of Pathology and Parasitology, Addis Ababa University, Bishoftu, Ethiopia.
Jazyk:	angličtina
Zdroj:	Frontiers in veterinary science [Front Vet Sci] 2020 Oct 08; Vol. 7, pp. 575881. Date of Electronic Publication: 2020 Oct 08 (Print Publication: 2020).
DOI:	10.3389/fvets.2020.575881
Abstrakt:	Cryptosporidium , a protozoan parasite in the phylum Apicomplexa, is the etiological agent of cryptosporidiosis, an intestinal infection characterized by profuse watery diarrhea. Over 30 species of Cryptosporidium are recognized, some host specific whereas others infect a broader host range. Cryptosporidium hominis and Cryptosporidium parvum are the species most commonly associated with human infection; C. hominis is largely associated only with human infections, but C. parvum is also associated with infection in animals, especially young ruminants. In some regions, cryptosporidiosis is a serious veterinary problem, particularly for calves, and lambs. Many outbreaks of human cryptosporidiosis have been associated with zoonotic transmission following contact with infected animals. In Africa, where cryptosporidiosis is a major contributor to pediatric morbidity and mortality, evidence suggests transmission is principally anthroponotic. Given the frequent close contact between humans and animals in Africa, the apparent predominance of human-to-human transmission is both interesting and puzzling. In this article, after a brief "text book" introduction to the parasite, we consider in separate sections the different aspects of relevance to Cryptosporidium transmission in African countries, describing different aspects of the various species and subtypes in human and animal infections, considering livestock management practices in different African countries, and looking for any characteristic "hot spots" where zoonotic transmission has apparently occurred. Studies where transmission networks have been investigated are particularly relevant. Finally, in a separate section, we try to gather these different strands of evidence together in order to assess the reasons behind the apparent predominance of anthroponotic transmission in Africa. Reviewing the available evidence provides an opportunity to re-think transmission pathways, not only in Africa but also elsewhere, and also to pose questions. Does the predominance of human-to-human transmission in Africa reflect a relative absence of zoonotic C. parvum in African livestock? Are Africans less susceptible to zoonotic Cryptosporidium infection, perhaps resulting from early immunostimulation by C. hominis or due to inherent genetic traits? Is the African environment-in all its variety-simply more detrimental to oocyst survival? Will the so-called hypertransmissible subtypes, currently relatively rare in Africa, be introduced from Europe or elsewhere, and, if so, will they fade out or establish and spread? Our intention with this manuscript is not only to summarize and consolidate diverse data, thereby providing an overview of data gaps, but also to provide food for thought regarding transmission of a parasite that continues to have a considerable impact on both human and animal health. (Copyright © 2020 Robertson, Johansen, Kifleyohannes, Efunshile and Terefe.)
Databáze:	MEDLINE
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