Table 1.
Prevalence of Cryptosporidium and Giardia in African countries (2010–2016)
| Country | Study population | Age group | Percentage positive for Giardia
(No. positive/No. tested) |
Percentage positive for Cryptosporidium (No. positive/No. tested) | Diagnostic technique | Genotyping (target gene) |
Reference |
|---|---|---|---|---|---|---|---|
| Algeria | Patients with digestive disorders | ≤ 80 years | 3.6% (38/1042) | 0.1% (1/1042) | Direct wet mount, formal ether concentration, iodine solution and acid fast staining | Not genotyped | [271] |
| Algeria | Sporadic cases | ≤ 75 years | 41.7% (25/542) | – | Iodine staining | Not genotyped | [272] |
| Angola | Children (with and without diarrhoea) | ≤ 12 years | 0.1% (44/328); 21.6% (73/338) | 30.0% (101/337) | Iodine and acid fast staining, and immunoassay | Not genotyped | [273, 274] |
| Botswana | Children with diarrhoea | < 5 years | 60.0% (45/75) | Not stated | Not genotyped | [41] | |
| Burkina Faso | Patients with diarrhoea | All ages | 26.5% (77/291) | Acid fast staining | Not genotyped | [275] | |
| Cameroon | Individuals from Nloh and Bawa villages | Not specified | 7.1% (14/197) | 1.5% (3/194) | Immunoassay | Not genotyped | [276] |
| Cameroon | HIV/AIDS-positive and negative individuals | 15–70 years | 0.3% (1/396) | 2.5% (10/396); 6.0% (12/200); 14.4% (46/320) | Direct microscopy, formal ether concentration, iodine and acid fast staining | Not genotyped | [277–279] |
| Central Africa Republic | Employees at Dzanga-Sangha Park | Not specified | 2.1% (1/48) | PCR | tpi | [122] | |
| Central African Republic | Children (with and without diarrhoea) | Not stated; < 5 years | 15.6% (27/173); 4.4% (29/666) | 10.4% (18/173); 7.7% (51/666) | Merthiolate iodine formaldehyde concentration, acid fast staining, immunoassay and multiplex PCR | Not genotyped | [29, 280] |
| Chad | Individuals from different regions | ≤ 76 years | 3.5% (16/462) | Merthiolate-iodine-formaldehyde concentration | Not genotyped | [281] | |
| Chad | European military UN peace keepers | 21–51 years | 22.3% (55/247) | Direct microscopy and iodine staining | Not genotyped | [282] | |
| Côte d’Ivoire | Individuals with intestinal disorders, persistent diarrhoea and controls | ≥ 1 year | 19.9% (61/307); 29.0% (39/136) | 6.2% (19/307); 8.8% (12/136) | Direct microscopy, iodine staining, formol ethyl-acetate concentration, formalin-ether concentration, immunoassay and PCR | bg; 18S rRNA; COWP | [106, 283] |
| Côte d’Ivoire | Children | ≤ 19 years | 21.6% (66/306); 20.7% (25/121) | Direct microscopy, iodine staining, formol-ethyl acetate concentration, ether-concentration technique | Not genotyped | [284, 285] | |
| Democratic Republic of Congo | HIV/AIDS-positive individuals | 15–73 years | 1.7% (3/175) | 9.7% (17/175); 5.4% (13/242) | Modified Ritchie formalin-ether concentration, acid fast staining and PCR assay | 18S rRNA | [28, 286] |
| Egypt | Individuals with livestock in their household | ≤ 60 years | 19.0% (55/290) | Acid fast staining | COWP | [108] | |
| Egypt | Individuals with and without diarrhoea | All ages | 12.5% (15/150) to 27.3% (75/330) | 5.9% (23/391) to 72.2% (52/92 | Direct microscopy, formalin-ethyl acetate sedimentation, acid fast, iodine and trichrome staining, immunoassay and PCR | COWP; tpi; gdh; bg | [105, 121, 131, 287, 288] |
| Egypt | Children (with and without diarrhoea) | < 18 years | 18.9% (224/1187) to 29.2% (47/161) | 2.1% (15/707) to 49.1% (81/165) | Direct microscopy, modified Ritchie’s biphasic concentration, iodine and acid fast staining, immunoassay and PCR | 18S rRNA; TRAP-C2; COWP; tpi; gdh; bg | [26, 80, 95, 132, 167, 289–292] |
| Egypt | Mentally handicapped individuals | All ages | 8.5% (17/200) | 23.5% (47/200) | Trichrome and acid fast staining | Not genotyped | [293] |
| Egypt | Children with acute lymphoblastic leukemia and controls | ≤ 15 years | 18.2% (10/55) | Acid fast staining and serum immunoassay | Not genotyped | [294] | |
| Egypt | Municipality solid-waste workers | 21–59 years | 3.8% (13/346) | 23.4% (81/346) | Formol-ether concentration and acid fast staining | Not genotyped | [67] |
| Equatorial Guinea | HIV-positive and negative individuals | ≤ 76 years | 14.2% (44/310); 4.2% (14/333) | 2.7% (9/333) to 18.1% (31/171) | Direct microscopy, formol-ether concentration, iodine and acid fast staining, Immunoassay and PCR | COWP | [152, 295, 296] |
| Ethiopia | HIV-positive and negative individuals | ≤ 86 years | 4.0% (15/378) to 7.9% (39/491) | 8.5% (32/378) to 26.9% (140/520) | Direct microscopy, formol-ether concentration, iodine and acid fast staining and PCR | 18S rRNA | [23, 267, 297–300] |
| Ethiopia | Children | ≤ 15 years | 4.6% (16/350) to 55.0% (216/393) | 4.6% (18/393) to 7.3% (28/348) | Direct microscopy, formol-ether concentration, iodine and acid fast staining, immunoassay and PCR | 18S rRNA; tpi; gdh; bg | [103, 125, 299, 301] |
| Ethiopia | Individuals with diarrhoea or gastrointestinal symptoms | ≤ 80 years | 10.9% (10/92) | 1.1% (1/92); 7.6% (79/1034) | Direct microscopy, acid fast staining, immunoassay and PCR | 18S rRNA; COWP; gdh; bg | [82, 99] |
| Ghana | Children (with and without diarrhoea/gastrointestinal symptoms) | ≤ 17 years | 1.0% (1/101) to 37.9% (455/1199) | 4.9% (59/1199) to 8.5% (204/2400) | Direct microscopy, formol-ether concentration, iodine and acid fast staining, immunoassay and PCR | 18S rRNA; gdh | [98, 135, 302–305] |
| Ghana | HIV-positive and negative individuals | All ages | 12.6% (101/800) | 8.2% (34/413); 9.0% (72/800) | Direct microscopy, formol-ether concentration, iodine and acid fast staining | Not genotyped | [306, 307] |
| Ghana | Food vendors | 10–70 years | 10.7% (15/140) | Direct microscopy, iodine staining and formalin-ether concentration | Not genotyped | [308] | |
| Guinea-Bissau | Children from villages | ≤ 7.5 years | 56.0% (28/50) | Ritchie concentration method and PCR | 18S rRNA; bg | [309] | |
| Guinea Bissau | Children (with and without malnutrition) | < 5 years | 33.9% (37/109) | Direct microscopy | Not genotyped | [310] | |
| Kenya | Certified food-handlers | ≥ 18 years | 1.3% (4/312) | Iodine staining | Not genotyped | [311] | |
| Kenya | HIV/AIDS-positive patients | ≥ 18 years | 34.1% (56/164) | Immunoassay and PCR | 18S rRNA | [25] | |
| Kenya | Individuals in villages | ≤ 81 years | 41.3% (329/796) | <1% | Multi-parallel qPCR | Not genotyped | [81] |
| Kenya | Children (with and without diarrhoea) | ≤ 15 years | 4.6% (98/2112) to 11.1% (109/981) | 3.7% (36/981) to 9.8% (31/317) | Direct microscopy, formal-ether concentration, acid fast staining, immunoassay and PCR | 18S rRNA; tpi; gdh; bg | [71, 88, 115, 136, 312, 313] |
| Libya | Children with diarrhoea | ≤ 5 years | 1.3% (3/239) | 2.1% (5/239) | Immunoassays | Not genotyped | [314] |
| Libya | Individuals with diarrhoea | Not specified | 1.3% (4/305) | 2.3% (7/305) | Direct microscopy, iodine, eosin and acid fast staining, concentration methods | Not genotyped | [315] |
| Madagascar | Children (with and without diarrhoea) | < 5 years | 11.7% (314/2692) | Direct microscopy and iodine staining | Not genotyped | [316] | |
| Madagascar | Individuals from rural southeastern Madagascar | Not specified | 0.8% (1/120) | PCR-RFLP | 18S rRNA | [97] | |
| Mali | European soldiers | Not specified | 3.8% (2/53) | 5.7% (3/53) | Multiplex real time PCR | Not genotyped | [317] |
| Morocco | Children (urban and rural) | 5–15 years | 12.5% (84/673) | Iodine, acid fast and Giemsa staining and Faust’s and Ritchie’s concentration methods | 18S rRNA; gdh | [318] | |
| Mozambique | HIV-positive and negative individuals | < 5 years | 6.5% (6/93) | Direct microscopy and Ritchie’s concentration method | Not genotyped | [319] | |
| Nigeria | Children (with and without diarrhoea or gastroenteritis) | ≤ 15 years | 37.2% (74/199) | 1.0% (2/199) to 46.8% (88/188) | Direct microscopy, acid fast staining, immunoassay and qPCR (18S rRNA gene) | 18S rRNA | [86, 87, 141, 320–323] |
| Nigeria | HIV/AIDS-positive and negative individuals | ≤ 80 years | 1.9% (9/476) to 3.2% (5/157) | 1.9% (3/157) to 35.9% (171/476) | Direct microscopy, acid fast staining, PCR-RFLP | 18S rRNA; tpi; ITS rDNA | [83, 101, 166, 324, 325] |
| Rwanda | Children | ≤ 18 years | 35.7% (222/622); 59.7% (366/583) | Direct microscopy, ether-based concentration, real-time PCR assays and multiplex qPCR |
tpi | [22, 24, 326] | |
| São Tomé and Príncipe | Children (with and without diarrhoea) | ≤ 10 years | 8.3% (29/348); 41.7% (185/444) | 5.5% (19/348) | Direct microscopy, modified water-ether sedimentation, formol-ether concentration, iodine and acid fast staining and PCR-RFLP | 18S rRNA; tpi | [96, 327] |
| Senegal | Children (with and without diarrhoea) | < 15 years | 6.13% (23/375) | Acid fast stain and immunoassay | Not genotyped | [328] | |
| South Africa | Children (with and without diarrhoea) | ≤ 11 years | 9.9% (16/162) | 5.6% (8/143); 12.2% (54/442) | Acid fast staining and PCR | 18S rRNA | [89, 154, 329] |
| South Africa | HIV-positive individuals | All ages | 11.9% (18/151) | 65.5% (165/252); 26.5% (40/151) | Acid fast stain, immunoassay, qPCR, PCR (18S rDNA) and loop-mediated isothermal amplification (LAMP) | Not genotyped | [330, 331] |
| Sudan | Inhabitants of rural areas | All ages | 13.3% (115/866) | Acid fast staining | Not genotyped | [332] | |
| Sudan | Children (with and without diarrhoea) | ≤ 13 years and primary school-aged | 10.1% (91/900) to 33.4% (167/500) | Direct microscopy and concentration technique | Not genotyped | [333–336] | |
| Sudan | Food handlers | 4–57 years | 20.5% (16/259) | Direct microscopy | Not genotyped | [337] | |
| Sudan | Individuals with diarrhoea | 1–80 years | 22.0% (22/100) | Direct microscopy, formal ether concentration technique | Not genotyped | [338] | |
| Tanzania | Individuals with and without diarrhoea | All ages | 6.9% (218/3152); 53.4% (93/174) | 1.1% (2/174) | Formol-ether-concentration technique, iodine and acid fast staining, qPCR and conventional PCR | 18S rRNA | [339, 340] |
| Tanzania | Children (with and without diarrhoea) | < 5 years, school going age | 1.9% (5/270) to 62.2% (28/45) | 10.4% (131/1259); 18.9% (51/270) | Multiplex real-time PCR and immunoassays | 18S rRNA; gdh | [72, 123, 341] |
| Tanzania | Individuals living in and around Gombe National Park | Not stated | 4.3% (8/185) | PCR-RFLP | 18S rRNA | [102] | |
| Tanzania | HIV-positive individuals | 30–43 years | 9.6% (8/83) | Direct microscopy and iodine staining | Not genotyped | [342] | |
| Tunisia | Children (with and without diarrhoea) | < 5 years | 1.7% (7/403) | Acid fast staining | 18S rRNA | [114] | |
| Uganda | Individuals from villages near Kibale National | ≤ 75 years | 40.7% (44/108) | 32.4% (35/108) | Real-time PCR, nested PCR | COWP; ef1-α; gdh; 18S rRNA; tpi | [107, 120] |
| Uganda | HIV-positive patients with Diarrhoea | 10–69 years | 3.6% (4/111) | Acid fast staining | Not genotyped | [343] | |
| Uganda | Children (non-symptomatic and HIV seronegative) | ≤ 12 years | 20.1% (86/427) | 12.5% (116/926) | Direct microscopy, acid fast staining and PCR | 18S rRNA; bg; gdh; tpi | [344, 345] |
| Zambia | Pre-school children | ≤ 7 years | 29.0% (117/403) to 29.0% (228/786) | 28.0% (113/403) to 30.7% (241/786) | Immunofluorescence stain | Not genotyped | [128, 346, 347] |
| Zimbabwe | Individuals in urban areas | All ages | 2.7% (8/300) | 6.3% (19/300) | Acid fast staining | Not genotyped | [348] |
Abbreviations: bg, beta-giardin; COWP, Cryptosporidium oocyst wall protein gene; ef1-α, elongation factor 1-alpha; gdh, glutamate dehydrogenase; ITS, internal transcribed spacer; 18S rRNA, 18S ribosomal ribonucleic acid; tpi, triose phosphate isomerase gene; TRAP, thrombospondin-related adhesive protein