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Treatment and prevention of cryptosporidiosis: what options are there for a country like Zambia?

Published online by Cambridge University Press:  15 February 2011

PAUL KELLY
PAUL KELLY*
Affiliation:
Barts and The London School of Medicine, Queen Mary University of London, London; Tropical Gastroenterology and Nutrition group, University of Zambia School of Medicine, Lusaka, Zambia
*
Corresponding author: Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine, Queen Mary University of London, Turner Street, London E1 2AD. Tel: 020 7882 2643. Fax: 020 7882 7192. E-mail: m.p.kelly@qmul.ac.uk
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Summary

Cryptosporidiosis is a major infection of humans, leading to diarrhoea and growth failure in children, diarrhoea and malnutrition in immunocompromised adults, and is associated with increased mortality in all age groups. Using the country of Zambia as an example, I review the possible approaches to treatment and prevention in a tropical setting. The current optimal therapy for cryptosporidiosis is nitazoxanide which works well in HIV uninfected children, but treatment in patients with HIV infection remains remarkably difficult. No single drug has demonstrated efficacy in a randomised trial. No vaccine is available, so the best option for prevention for the moment is filtration and clean storage of drinking water. This would be expected to reduce cryptosporidiosis dramatically, but this needs to be demonstrated directly. Water filtration would have the added benefit of protection against many other pathogens, but the paucity of alternative approaches highlights the need for a better understanding of this important human pathogen.

Keywords

CryptosporidiosisCryptosporidiumvaccinediarrhoeal diseasenitazoxanideparomomycinAfricawater filtration
Type
Research Article
Information
Parasitology , Volume 138 , Special Issue 12: Symposia of the British Society for Parasitology Volume 47 , October 2011 , pp. 1488 - 1491
Copyright
Copyright © Cambridge University Press 2011

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