Symptomatic and Asymptomatic Cryptosporidium Infections in Children in a Semi-Urban Slum Community in Southern India

Cryptosporidium is a leading cause of childhood diarrhea in de eloping countries We investigated symp tomatic and asymptomatic cryptosporidiosis in 20 children less than two years of age in a semi urban slum in southern India All surveillance (conducted every two weeks) and diarrheal samples from 20 children (n = 1 036) with cryptospo ridial diarrhea previously identified by stool microscopy were tested by polymerase chain reaction restriction fragment length polymorphism for species and subgenotype determination Thirty five episodes of cryptosporidiosis were identified in 20 children of which 25 were diarrhea' Fifteen episodes were associated with prolonged oocyst shedding Multiple episodes of cryptosporidiosis occurred in 40% of the children Most infections were with C hominis, subtype la Children with multiple infections had significantly lower weight for age and height for age Z scores at 24 months but had scores comparable with children with a single episode by 36 months Multiple symptomatic Cryptosporidium infections associated with prolonged oocyst shedding occur frequently in this disease endemic area and may contribute to the long term effects of cryptosporidiosis on physical growth in these children