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Indian Journal of Medical Microbiology, Vol. 26, No. 2, April-June, 2008, pp. 203-204 Correspondence Microscopy for Cryptosporidiosis Screening in Remote Areas Barua P, Hazarika NK, Barua N, Rasul E, Laskar N Regional Medical Research Centre, Dibrugarh Date of Submission: 05-Oct-2007 Code Number: mb08063 Dear editor, Cryptosporidium parvum has been responsible for numerous outbreaks of diarrhoeal diseases. [1],[2] In immunocompetent host, the disease is self-limiting but in immunocompromised individual, the disease can become chronic and debilitating. With the increasing number of individuals with HIV/AIDS, cancer patients and malnourished children suffering from diarrhoeal illness, need for an easy, cheap and quick method of diagnosis is required to reduce morbidity. Though ELISA has been widely used as a diagnostic tool, availability of this facility is still poor in peripheral set-up. In this backdrop we wanted to evaluate microscopy vis-à-vis ELISA in screening stool samples for cryptosporidia in remote areas. Faecal specimens were collected from immunocompromised ( n = 72) and healthy individuals ( n = 20) attending the outpatient department or in the wards of Medicine, Paediatrics and Haematology of Gauhati Medical College. All the patients had acute or chronic diarrhoeal illness. Specimens were processed by standard protocol [3] while ELISA was performed using the commercially available kit (RIDASCREEN Cryptosporidium R-Biopharm Ag, Darmstadt, Germany). Cryptosporidium spp. was detected in 11 out of 72 stool specimen by microscopy; while four specimens showed positivity by ELISA. The other parasites isolated are shown in the table. The sensitivity and specificity of ELISA in detection of Cryptosporidial coproantigen was 36.4 and 100% respectively while the negative predictive value (NPV) and positive predictive value (PPV) for the same was 89.7 and 100% respectively. In our study, we found microscopy more efficacious than performing ELISA in terms of time, equipment and cost for routine diagnosis in remote setup. Modified Z-N staining technique, has been reported to be superior to other diagnostic methods. [4] Our study is in agreement with them and the findings tally with those of Kehl et al. , [5] with respect to superior efficacy of microscopy in respect to ELISA as a procedure for routine diagnosis. The patterns of sensitivity and specificity in our study suggest that microscopy would suffice routine screening of stool specimen for Cryptosporidium spp. References
Copyright 2008 - Indian Journal of Medical Microbiology The following images related to this document are available:Photo images[mb08063t1.jpg] |
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