Prevalence and clinical features of Cryptosporidium infection in hemodialysis patients

Aim: This cross-sectional study aims to assess the prevalence of Cryptosporidium in hemodialysis patients compared with healthy individuals in central Iran from August 2014 to January 2015. Background: Cryptosporidiosis is a major cause of acute and persistent diarrhea with significant morbidity and mortality in immunocompromised patients such as those undergoing renal dialysis. Methods: Three stool samples were collected from 330 hemodialysis patients and 150 healthy individuals on 3 consecutive days. The samples were screened for Cryptosporidium infection using formalin-ether sedimentation and modified Ziehl-Neelsen staining. Demographic variables as well as risk factors were recorded. Results: Out of 330 dialysis patients and 150 healthy individuals, 10 (3%) and 1 (0.7%) were infected with Cryptosporidium, respectively. We found statistically significant differences between infection and place of residency, hygiene status, education level, diarrhea, and abdominal pain in the two groups (p<0.05). On the other hand, there was no relationship between infection and s ex, contact with domestic animals, fever, vomiting, nausea, flatulence, anorexia, duration of dialysis and underlying disorders in the two groups. Also, there was a statistically significant difference between age and infection in hemodialysis patients (p=0.003). A higher infection rate was observed in patients under 20 years of age. Conclusion: Risk factors for Cryptosporidium infection must be controlled. We strongly recommended that stool samples from such patients, especially those with severe or prolonged diarrhea, should be examined with modified Ziehl-Neelsen staining for appropriate and timely treatment.