Microsporidiosis in South Africa: PCR detection in stool samples of HIV-positive and HIV-negative individuals and school children in Vhembe district, Limpopo Province

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 101; no. 6; pp. 547 - 554
• Main Authors: Samie, A., Obi, C.L., Tzipori, S., Weiss, L.M., Guerrant, R.L.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2007; Royal Society of Tropical Medicine and Hygiene
• Subjects: Adolescent; Adult; Aged; AIDS-Related Opportunistic Infections - epidemiology; AIDS-Related Opportunistic Infections - parasitology; Child; Child, Preschool; Diarrhea; Enterocytozoon - isolation & purification; Enterocytozoon bieneusi; Feces - parasitology; Female; HIV; HIV Seronegativity; HIV Seropositivity - parasitology; Humans; Infant; Male; Microsporidia; Microsporidiosis - diagnosis; Microsporidiosis - epidemiology; Middle Aged; PCR; Polymerase Chain Reaction - methods; Prevalence; South Africa; South Africa - epidemiology; South Africa; Diarrhea; South Africa; HIV; Microsporidia; PCR; Enterocytozoon bieneusi
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/j.trstmh.2007.02.005

Microsporidia were initially recognized as pathogens of insects and fish but have recently emerged as an important group of human pathogens, especially in immune-compromised individuals, such as those with HIV infection. In this study, we used a PCR-RFLP assay confirmed by quantitative real-time PCR and trichrome staining to determine the prevalence of microsporidian infections among hospital patients and school children in Vhembe region. Enterocytozoon bieneusi was the only microsporidian species detected in these stool samples. It was found in 33 (12.9%) of 255 samples from the hospitals and in 3 (4.5%) of 67 samples from primary school children and was significantly associated ( P = 0.039) with diarrhea in HIV-positive patients (21.6%) compared to HIV-negative individuals (9%). However, microsporidian infections were not associated with intestinal inflammation as indicated by the lactoferrin test. These results suggest that microsporidia might be a cause of secretory diarrhea in HIV-positive patients. To our knowledge, this is the first report of E. bieneusi in the Vhembe region of South Africa. Further investigations are needed in order to clarify the pathogenesis of E. bieneusi in HIV-positive patients.