CRYPTO-POC

The primary objective of this study was to estimate the accuracy and operational performance of simple microscopy of auramine stained stool samples for diagnosis of Cryptosporidium infection. Secondary aims were to evaluate risk factors for Cryptosporidium infection and shedding over time. Approximately 1000 Ethiopian children below 5 years presenting to Jimma University Hospital or and Serbo health center with diarrhea over a 12-month enrollment period were included. Additionally, 750 healthy controls from health centers in the same area were also included. Clinical data, HIV test and a stool sample were collected and analyzed. The study was conducted between December 2016 and July 2018. Some analyses of microbiome data are still being analyzed.

Published results from the study showed that:

LED-AP has high sensitivity and specificity for cryptosporidiosis and should be considered as a dual-use technology that can be easily integrated with existing laboratory infrastructures in low-resource settings.

On average, children infected with Cryptosporidium continue to shed parasite oocysts in their stools for 31 days after the diarrhea episode started.

Diarrhea cases are associated with lower bacterial diversity and enriched in Escherichia spp., Campylobacter spp., and Streptococcus spp. Further, diarrhea cases are depleted in gut commensals such as P. copri, F. prausnitzii, and D. succinatiphilus, with depletion being most pronounced in prolonged/persistent cases.

Publications from the CryptoPOC study

Zangenberg M, Johansen ØH, Abdissa A, Eshetu B, Kurtzhals JAL, Friis H, Sommerfelt H, Langeland N, Hanevik K. Prolonged and persistent diarrhoea is not restricted to children with acute malnutrition: an observational study in Ethiopia. Trop Med Int Health. 2019 Sep;24(9):1088-1097. doi: 10.1111/tmi.13291. Epub 2019 Aug 16. PMID: 31325406.

Johansen ØH, Abdissa A, Zangenberg M, Mekonnen Z, Eshetu B, Bjørang O, Alemu Y, Sharew B, Langeland N, Robertson LJ, Hanevik K. Performance and operational feasibility of two diagnostic tests for cryptosporidiosis in children (CRYPTO-POC): a clinical, prospective, diagnostic accuracy study. Lancet Infect Dis. 2021 May;21(5):722-730. doi: 10.1016/S1473-3099(20)30556-9.

Johansen ØH, Abdissa A, Zangenberg M, Mekonnen Z, Eshetu B, Sharew B, Moyo S, Sommerfelt H, Langeland N, Robertson LJ, Hanevik K. A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children. PLoS Negl Trop Dis. 2022 Jun 6;16(6):e0010508. doi: 10.1371/journal.pntd.0010508.

Johansen ØH, Abdissa A, Bjørang O, Zangenberg M, Sharew B, Alemu Y, Moyo S, Mekonnen Z, Langeland N, Robertson LJ, Hanevik K. Oocyst Shedding Dynamics in Children with Cryptosporidiosis: a Prospective Clinical Case Series in Ethiopia. Microbiol Spectr. 2022 Aug 31;10(4):e0274121. doi: 10.1128/spectrum.02741-21.

Alemu Y, Abdissa A, Mekonnen Z, Sharew B, Johansen ØH, Bjørang O, Langeland N, Hanevik K, Moyo SJ; CRYPTO-POC study group. Prevalence and assemblage of Giardia duodenalis in a case-control study of children under 5 years from Jimma, Southwest Ethiopia. Parasitol Res. 2023 Dec 13;123(1):38. doi: 10.1007/s00436-023-08029-5

Tesfaw G, Siraj DS, Abdissa A, Jakobsen RR, Johansen ØH, Zangenberg M, Hanevik K, Mekonnen Z, Langeland N, Bjørang O, Safdar N, Mapes AC, Kates A, Krych L, Castro-Mejía JL, Nielsen DS. Gut microbiota patterns associated with duration of diarrhea in children under five years of age in Ethiopia. Nat Commun. 2024 Sep 2;15(1):7532. doi: 10.1038/s41467-024-51464-w.