Management of human cryptosporidiosis in Bulgaria, a country with low endemicity
Authors: Nina D. TSVETKOVA, Rumen N. HARIZANOV, Iskra G. RAINOVA, Iskren T. KAFTANDJIEV, Raina B. ENIKOVA, Nina S. YANCHEVA, Kalina S. PAVLOVA
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Introduction. Cryptosporidiosis is a protozoan infection, and in humans is most often caused by two species, Cryptosporidium parvum and C. hominis. The disease most often presents with diarrhea, and it has been defined by the World Health Organization (WHO) as a human immunodeficiency virus (HIV)-related infection. Although in Bulgaria the tests for cryptosporidiosis have been performed for almost thirty years, the disease is still insufficiently known to healthcare professionals.
The objective of the study was to determine the incidence and demographic characteristics of human cryptosporidiosis in Bulgaria for a 10-year period, from 2009 to 2018.
Material and methods. During the study period, a total of 2706 patients were examined for cryptosporidiosis by microscopic and immunochromatographic methods, of whom 2618 were immunocompetent and 88 were HIV-infected.
Results. 22 patients were diagnosed with oocysts of Cryptosporidium sp., of whom 15 were immunocompetent and 7 immunocompromised. The average annual incidence of the disease for the studied period was 0.03 per 100 000 population, and the level of this indicator is similar in some European Union countries such as Poland, Czech Republic, Latvia, Norway. The data from our study showed that the most affected were the age groups from 0 to 4 years and the female patients, and that the disease prevails in the summer months of the year.
Conclusions. In Bulgaria, human cryptosporidiosis has a low incidence rate, but in our opinion, this is mostly due to the fact that, currently, only а small number of laboratories perform tests, that hinder the determination of the actual prevalence among the population.