Table 2.

Use case scenarios for an anti-Cryptosporidium therapeutic for LMICs ^{adapted from 42}

Target population	Disease burden	Potential treatment sites	Potential treatment strategies	Current applicability: nitazoxanide
Young children aged 0–24 months	7.5 million cases with moderate-to-severe diarrhoea,2 133 000 deaths and 8.2M DALYs annually in LMICs7	Primary, secondary and tertiary health facilities in LMICs	Diagnosis-based treatment	Not approved in children under 12 months, only ~30% efficacy in malnourished9
			Empiric treatment in high-risk populations where diagnostic tools are not available	Insufficient evidence and guidelines
		Community based treatment	Mass drug administration in seasons with high prevalence	Insufficient evidence and guidelines
Malnourished children	Estimated 50 million wasted children globally.45 Recent studies indicate 10%–20% prevalence of cryptosporidiosis in children with acute malnourishment.9 46–48	Primary, secondary and tertiary health facilities in LMICs. Malnutrition care centres in clinics and hospitals	Diagnosis-based treatment	Poorly effective (~30% efficacious)9
			Empiric treatment in high-risk populations where diagnostic tools are not available	Insufficient evidence and guidelines. Nitazoxanide poorly effective9
Immunocompromised patients	Estimates range from 5% to 50% of PLWHA and up to 30% of solid organ transplant recipients.49–53	Primary, secondary and tertiary health facilities in LMICs. HIV/AIDS treatment programmes. Transplant centres in any global setting	Diagnosis-based treatment	Poorly or non-effective for PLWHA9 43 54
			Empiric treatment in high-risk populations where diagnostic tools are not available	Insufficient evidence and guidelines Poorly or non-effective for PLWHA9 43 54

Adapted from Ashigbie et al. ⁴²

DALYs, disability-adjusted life years lost; LMICs, low-income and middle-income countries; PLWHA, people living with HIV/AIDS.