Water filtration is the current practice for controlling these parasites; therefore, municipal programs for clean water are essential for protection. When municipal water is not available, boiling for at least 1 minute is an effective method of controlling these parasites in the water supply. Dawson, D. Food protozoan parasites.
International Journal of Food Microbiology — Parasites and Foodborne Illness. Accessed August CFAES provides research and related educational programs to clientele on a nondiscriminatory basis. For more information, visit cfaesdiversity. For an accessible format of this publication, visit cfaes. Skip to main content. Family and Consumer Sciences. What is a parasite? Public health consequences Parasitic diseases are not common in the United States. Susceptible groups Everybody is susceptible to illness caused by parasites.
Treatment People with healthy immune systems are usually able to clear an infection without medical help. Pathogen control These parasites are not effectively controlled by chlorination or other disinfectants. Tips to avoid parasitic infections Some steps to take to protect you from these parasites: Wash your hands with soap and warm water.
Drink water from safe sources such as municipal water. Wash all raw fruits and vegetables under running water from a safe source. You can also call Healthline on Skip to main content. Cryptosporidium and Giardia Share. Cryptosporidium and Giardia HE Code:.
Publication date:. Revision date:. Infectious diseases and viruses. View online Download PDF. Order free copies:. Information on preventing food- and waterborne diseases. About these diseases and how to prevent them. How do you get cryptosporidium or giardia? Symptoms and illness Cryptosporidium and giardia have similar symptoms. You may have some or all of the following symptoms: foul-smelling or watery diarrhoea stomach cramps or pain lack of appetite weight loss bloating nausea and vomiting slight fever fatigue feeling very tired flatulence wind headache.
Treating cryptosporidium and giardia If you think you have cryptosporidium or giardia, this is what you should do. Go to your doctor. They may ask to test a specimen small amount of your faeces for cryptosporidium or giardia. Your doctor will give you advice on how to collect the specimen and what to do with it. Cryptosporidium hominis and C.
Out of the 56 molecular studies in African countries analysed, C. In immunocompromised individuals, the prevalence of C. In comparison, the prevalence of C. Other Cryptosporidium species including C.
Subtyping studies of Cryptosporidium to date supports the dominance of anthroponotic transmission in African countries, despite close contact with farm animals. For example, a study conducted in children in the rural Ashanti region of Ghana reported that the human-to-human transmitted C.
High levels of subtype diversity are also frequently reported, which is a common finding in developing countries and is thought to reflect intensive and stable anthroponotic Cryptosporidium transmission [ 6 , 23 , 89 , 96 , 98 , , ]. Similarly, another study in Kenyan children identified C. To date, seven C. The mainly anthroponotically transmitted C.
However, it is important to note that the IIc subtype family has been detected in hedgehogs in Europe [ — ], suggesting potential zoonotic transmission. In addition to the C. The C. High occurrences of zoonotic C. Few subtyping studies have been conducted on C. Recently a gp60 subtyping assay has been developed for C. A single case of XVaA3b originating in Kenya has been identified and nine samples from Ethiopia belonged to XVaA3d; however, this subtype is not a strictly African subtype as the same subtype was also identified in a United Kingdom patient with a history of traveling to Barbados [ ].
Currently no animal reservoir has been identified for C. The relative clinical impact of C. In a study in children under 15 years in Ghana, C. A study in Tanzania reported that C.
However, another study in Uganda reported that the vast majority of children presenting with diarrhoea lasting for 31 days or longer were HIV-positive and were infected with isolates belonging to the C. Relatively few Giardia genotyping studies have been conducted in Africa, however available reports reveal that five G. In Africa, Assemblage B was the most prevalent among typed samples Although many studies have reported that Giardia is not associated with severe diarrhoea [ 8 ], one study reported that the prevalence of G.
Assemblage C was detected in an adult immunocompromised male suffering from bladder cancer and diarrhoea in Egypt [ ] and Assemblage F was reported in six diarrhoeal and one asymptomatic individual in Ethiopia [ ].
In that study, four of the identified Assemblage F isolates were mixed infections with Assemblage A. Assemblage E has been reported in humans in three separate studies in Egypt with a prevalence of up to In Africa, Cryptosporidium and Giardia have been reported in several domesticated animal species including cattle, sheep, goats, farmed buffalo, horses, poultry chicken and turkey , pigs, cultured tilapia fish and dogs [ 26 , 84 , 93 , 94 , 97 , , , — ].
However, the majority of research has been conducted on cattle. As with most studies, the prevalence of Cryptosporidium was greater in young animals 1 day to 3 months than older ones. Age, source of drinking water and diarrhoea has been associated with Cryptosporidium prevalence in cattle [ 26 , , ]. For example, in a study in Egypt, calves watered with canal or underground water were at a higher risk of infection than calves watered with tap water [ 26 ].
Cryptosporidium parvum, C. Younger calves had a higher occurrence of C. Although little research has been done in other domesticated animals, C. In addition, C. Cryptosporidium meleagridis was identified in both turkeys and chickens [ 93 , ] and C.
All the species reported in domesticated animals, except for C. Humans working closely with farmed animals especially calves are known to be more at risk of zoonotic infection with C. Subtyping of C. Giardia duodenalis Assemblage E is the dominant species in ruminant livestock cattle, farmed buffalo and goats from the Central African Republic, Egypt, Rwanda, Tanzania and Uganda [ 80 , , — , , , ].
Assemblage A was also identified in cultured tilapia and mullet Tilapia nilotica and Mugil cephalus , respectively from Egypt [ ]. The majority of studies on Cryptosporidium and Giardia in African wildlife have been conducted in wildlife parks. These studies have included western lowland gorillas from the Lope National Park in Gabon [ ], mountain gorillas from the Bwindi Impenetrable National Park in Uganda and the Volcanoes National Park in Rwanda [ , , , , ], chimpanzees from Tanzania, elephants, buffalos and impalas from the Kruger National Park, South Africa [ 90 , ], olive baboons from the Bwindi Impenetrable National Park, Uganda [ ] and bamboo lemurs and eastern rufous mouse lemurs from the Ranomafana National Park, Madagascar [ 97 , ].
In addition, Cryptosporidium oocysts and Giardia oo cysts together with other gastrointestinal parasites Nasitrema attenuata , Zalophotrema spp. Cryptosporidium hominis was reported in olive baboons from Kenya and Tanzania and in lemurs from Madagascar, suggesting possible spill-back from humans.
Subtyping at the gp60 locus identified C. In wild ruminants, C. Cryptosporidium ubiquitum is considered an emerging zoonotic pathogen [ ] and has been reported in humans in Africa in Nigeria [ 86 , ] and increasing human encroachment into wildlife-populated areas in Africa, is likely to increase zoonotic transmission.
Giardia duodenalis cysts have been found in the faeces of other animals including grasscutters Thryonomys swinderianus [ ], but no genotyping was done. Almost all the Cryptosporidium and Giardia species identified in wildlife are infectious to humans with potential for zoonosis or spill-back from humans to animals. Relatively little is known about the presence and prevalence of Cryptosporidium and Giardia in food and water in Africa.
Both parasites have been detected in food such as fresh fruits and vegetables in Ethiopia, Egypt, Ghana, Libya and Sudan [ — ], and Tiger nuts Cyperus esculentus from Ghana [ ]. Cryptosporidium was detected in Cryptosporidium does not multiply in bivalves, but they can be an effective transmission vehicle for Cryptosporidium oocysts, especially within 24—72 h of contamination, with viable oocysts present in bivalves up to 7 days post infection [ ].
Cryptosporidium and Giardia oo cysts were identified from As coins and banknotes are some of the objects most handled and exchanged by people, this raises the potential of parasite transmission even between countries. In many rural African households, untreated water is used for various purposes such as bathing, cooking, drinking and swimming, often exposing them to waterborne Cryptosporidium and Giardia [ , ].
More than million people in sub-Saharan Africa have poor access to safe water, predisposing them to infections from waterborne pathogens, and cryptosporidial infections are known to be prevalent among communities which lack access to clean potable water supply [ — ].
Poverty is therefore a key limiting factor to accessing safe water. This, coupled with inadequate water treatment, poor hygiene practices, drinking unboiled water and lack of education programmes, predisposes many rural African communities to cryptosporidiosis and giardiasis [ ]. They have also been detected in water sources surface and well , treated water storage tanks and tap water in Ethiopia [ , ], the Kathita and Kiina rivers and surface water in Kenya [ , ], water from wells and the Kano river in Nigeria [ ], the surface waters of the Vaal Dam system [ ], treated and untreated effluents, sewage, drinking water and roof-harvested rainwater in South Africa [ — ].
In Tunisia, they have been detected in watersheds, treated, raw wastewater and sludge samples [ , ], in Uganda, in natural and communal piped tap water from the Queen Elizabeth protected area [ ], in piped water in Zambia [ , ] and wells, springs, tap water and rivers in Zimbabwe [ ].
Genotyping of Cryptosporidium and Giardia from these water sources identified C. In the latter report, the most prevalent genotypes were Assemblage A Another contributing factor to the high prevalence and widespread distribution of Cryptosporidium and Giardia in Africa is the lack of treatment options.
The ineffectiveness of nitazoxanide in HIV-positive individuals and the contribution of malnourishment to impaired immunity [ 30 ], means that nitazoxanide is ineffective against the most important target population in Africa.
In individuals co-infected with HIV, antiretroviral therapy ART has been successful in controlling chronic diarrhoea and wasting due to cryptosporidiosis [ 27 , , ].
As with Cryptosporidium , a human vaccine for giardiasis is not available. Several classes of antimicrobial drugs are available for the treatment of giardiasis. The most commonly utilised worldwide are members of the 5-nitroimidazole 5-NI family such as metronidazole and tinidazole. For Cryptosporidium , new classes of more effective drugs are a high priority and for Giardia , improvements in potency and dosing of currently available drugs, and the ability to overcome existing and prevent new forms of drug resistance, are priorities in antigiardial drug development [ ].
Treatment of Cryptosporidium and Giardia in African countries, despite having a large target population, has a small market in the developed world and pharmaceutical companies are often hesitant to invest in costly de novo campaigns to develop new therapeutics for developing countries.
Therefore, the primary challenge for further drug development is the underlying economics, as both parasitic infections are considered Neglected Diseases with low funding priority and limited commercial interest [ ]. Waterborne transmission is a major mode of transmission for both Cryptosporidium and Giardia. Climate change represents a major threat for access to safe drinking water in Africa which has more climate sensitive economies than any other continent [ ].
Increasingly variable rainfall patterns are likely to affect the supply of fresh water in Africa. Some regions in Africa have become drier during the last century e. Climate change will also increase levels of malnutrition in Africa, as it will lead to changes in crop yield, higher food prices and therefore lower affordability of food, reduced calorie availability, and growing childhood malnutrition in Sub-Saharan Africa [ ]. Malnutrition in turn undermines the resilience of vulnerable populations to cryptosporidial and giardial infections, decreasing their ability to cope and adapt to the consequences of climate change.
Surface water concentrations of Cryptosporidium and Giardia in Africa are also expected to increase with increased population growth.
Given the lack of treatment options, particularly for Cryptosporidium , high-level community awareness, policy formulations and regular surveillance are needed in order to limit the waterborne, zoonotic and anthroponotic transmission of Cryptosporidium and Giardia. This cannot be achieved, however, unless there is a commitment from African governments to supply clean potable water, particularly to rural communities, improve sanitation by connecting the population to sewers and improve waste water treatment.
Community programmes must be initiated to educate the people on water safety measures, personal hygiene and water treatment processes. The achievement of these goals hinges on the elimination of malnutrition and a significant reduction in HIV levels in African populations. Furthermore, it has been suggested that HIV protease inhibitors can act as antiparasitic drugs.
For example, in experimental studies, the drugs indinavir, saquinavir, and ritonavir have been reported to have anti- Cryptosporidium spp. However, most African government have not invested sufficient funds and resources to ensuring alleviation of malnutrition and HIV [ , ] and many HIV-prevention services still do not reach most of those in need [ ], largely due to under-staffing of, and the poor geographical distribution of available services for those in need.
Despite the millennium development goals target to reduce hunger by half by , major failures have been recorded in Africa. The situation is currently getting worse in this region as it moved from This increase has generally been attributed to poverty, illiteracy, ignorance, big family sizes, climate change, policy and corruption [ ].
Cryptosporidium and Giardia are prevalent in both humans and animals in Africa with both anthroponotic and zoonotic transmission cycles. Cryptosporidium is unequivocally associated with moderate-to-severe diarrhoea in African children but further studies are required to determine if Giardia infections in early infancy are positively linked to moderate-to-severe diarrhoea, whether some paediatric hosts e.
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