Table 3.
Overview of articles for which zoonotic transmission of Cryptosporidium species other than C. parvum in Africa is suggested.
| Country | Evidence of zoonotic transmission provided | Evaluation of evidence* | References |
|---|---|---|---|
| C. meleagridis | |||
| Côte d'Ivoire | 9 people with intestinal disorders attending village primary healthcare centers; C. meleagridis also found in 4 chickens; age or symptoms not further specified | Moderate | (57) |
| Egypt | Patients with gastrointestinal symptoms (n = 2) | Weak | (114) |
| Equatorial Guinea | HIV infected female, also positive by antigen test and microscopy; symptoms not specified | Weak | (115) |
| Ethiopia | 3 HIV positive children; symptoms not specified | Moderate | (65) |
| Gabon | 1 child with diarrhea; but no confirmed transmission cluster involving animal contacts (however, birds not sampled) | Weak | (76) |
| Ghana | 3 children with diarrhea; but no confirmed transmission cluster involving animal contacts (however, birds not sampled) | Moderate | (76) |
| Kenya | HIV positive adult patients, 2 with diarrhea, 1 without diarrhea | Moderate | (108) |
| Kenya | 6 pediatric patients; microscopy positive; symptoms not specified | Moderate | (116) |
| Kenya | 1 HIV infected patient; microscopy also positive, age or symptoms not specified | Weak | (117) |
| Kenya | 1 person, no demographic or clinical information | Weak | (118) |
| Kenya | 1 HIV positive adult; symptoms not specified | Weak | (119) |
| Kenya | 1 child presenting to hospital; microscopy positive; symptoms not specified | Weak | (120) |
| Kenya | 2 pediatric patients with diarrhea; microscopy positive | Weak | (59) |
| Kenya | 1 child with diarrhea; ELISA antigen also positive | Weak | (121) |
| Madagascar | 5 children with diarrhea and 2 neighboring children of children with Cryptosporidium diarrhea; but no confirmed transmission cluster involving animal contacts (however, birds not sampled) | Moderate | (76) |
| Malawi | 2 pediatric patients with diarrhea; microscopy positive; rural area | Weak | (122) |
| Nigeria | 5 asymptomatic children; microscopy positive | Moderate | (64) |
| Nigeria | HIV-positive adult, asymptomatic; C. meleagridis also detected in 1 chicken from same area | Weak | (58) |
| South Africa | 1 child hospitalized with diarrhea; gp60 subtype was IIId (found in humans in India, but not reported in animals) | Weak | (123) |
| South Africa | 1 child from a clinic; microscopy positive; symptoms not specified | Weak | (66) |
| Tanzania | 1 child with diarrhea and 1 neighboring child with Cryptosporidium diarrhea; but no confirmed transmission cluster involving animal contacts | Weak | (76) |
| Tunisia | 3 children without diarrhea; microscopy positive | Moderate | (110) |
| Tunisia | 2 adult HIV patients, both with gp60 subtype IIIbA26G1R1; 1 immunocompromised child, not subtyped, in co-infection with C. hominis; symptoms not specified | Moderate | (111) |
| Tunisia | 2 children with primary immunodeficiency and diarrhea, one a co-detection with C. hominis; microscopy positive | Weak | (124) |
| Uganda | 3 hospital admitted children with persistent diarrhea | Moderate | (125) |
| C. muris | |||
| Kenya | 1 HIV positive adult with diarrhea; microscopy positive | Weak | (126) |
| Kenya | 1 child presenting to hospital; microscopy positive; symptoms not specified | Weak | (120) |
| Malawi | 1 child with diarrhea; co-detection with C. andersoni | Weak | (122) |
| Nigeria | 1 child with diarrhea; C. muris also detected in 1 goat in same area | Weak/moderate | (58) |
| C. felis | |||
| Ethiopia | 1 HIV positive child; symptoms not specified | Weak | (65) |
| Gabon | 1 household contact of a child with Cryptosporidium diarrhea | Weak | (76) |
| Ghana | 2 children with diarrhea; 1 household contact of child with Cryptosporidium diarrhea; 3 neighboring children of children with Cryptosporidium diarrhea; but no confirmed transmission cluster involving animal contacts | Moderate | (76) |
| Kenya | 4 pediatric patients with diarrhea; microscopy positive | Moderate | (59) |
| Kenya | 2 children presenting to hospital; microscopy positive; symptoms not specified | Weak | (120) |
| Nigeria | 2 adult HIV patients; symptoms not specified | Weak | (127) |
| Nigeria | 1 adult HIV patient; symptoms not specified | Weak | (128) |
| Tanzania | 2 neighboring children of children with Cryptosporidium diarrhea; but no confirmed transmission cluster involving animal contacts; symptoms not specified | Weak | (76) |
| C. canis | |||
| Ethiopia | 2 HIV positive children; symptoms not specified | Weak | (65) |
| Kenya | 3 children presenting to hospital; microscopy positive; symptoms not specified | Moderate | (120) |
| Kenya | HIV positive adult patients, 2 with diarrhea, 2 without diarrhea | Moderate | (109) |
| Kenya | 2 pediatric patients; microscopy positive; symptoms not specified | Weak | (116) |
| Kenya | 1 child with diarrhea; ELISA antigen positive | Weak | (121) |
| Nigeria | 1 adult HIV patient; symptoms not specified | Weak | (127) |
| Nigeria | 1 asymptomatic child; microscopy positive | Weak | (64) |
| C. suis | |||
| Kenya | HIV positive adult patients, 1 with diarrhea, 1 without diarrhea | Weak | (109) |
| Madagascar | 1 adult, no diarrhea; C. suis detected in 3 pigs in the same village | Weak | (129) |
| Madagascar | 1 child neighbor of a child with Cryptosporidium diarrhea; symptoms not specified; no confirmed transmission cluster involving animal contacts | Weak | (76) |
| C. ubiquitum | |||
| Nigeria | 3 asymptomatic children; microscopy positive (reported as “Cryptosporidium cervine genotype”) | Moderate | (64) |
| C. cuniculus | |||
| Nigeria | 5 asymptomatic children; microscopy positive (reported as “Cryptosporidium rabbit genotype”) | Moderate | (64) |
| C. xiaoi | |||
| Ethiopia | 2 HIV positive children; symptoms not specified | Weak | (65) |
| Ghana | 1 child with diarrhea (C. xiaoi/bovis); also identified in 19 goats and 5 sheep in the same region | Weak/moderate | (76) |
*
Strong: same zoonotic species or subtypes detected in ≥ 1 humans and animals with a plausible connection in time and space, or with other strong epidemiological and statistical evidence of animal contact being a risk factor.
Moderate: detection of zoonotic species or subtype in ≥ 3 humans, plus at least one of the following: gastrointestinal symptoms, immunocompromised, detection by ≥ 1 other testing modality.
Weak: other detection of zoonotic species or subtype.