Project Details

Development of an effective treatment of Cryptosporidiosis in Bangladeshi Children

Zannatun Noor, PhD

Summary

BACKGROUND: One of the most common problems encountered in pediatric practice is diarrhea and Cryptosporidiosis is one of the major causes of diarrhea in children in low- and middle-income countries. GAP: Currently, there is no approved vaccine against Cryptosporidium and the only approved drug for the treatment of diarrhea caused by this enteropathogen is nitazoxanide (NTZ). The lack of effective therapy for cryptosporidiosis remains an immense knowledge gap in the efforts to improve childhood health worldwide. HYPOTHESIS: Our hypothesis is that NTZ treatment failure in malnourished infants is due to a secondary immune deficiency that can be reversed by the appropriate therapeutic treatment. Lactobacillus reuteri DSM 17938 can have a potential immune modulating effect by altering gut microbiome promoting NTZ action. METHODS: In a pilot randomized clinical trial Cryptosporidium spp. positive Bangladeshi children from the Mirpur (Dhaka, Bangladesh) slum area were randomly assigned to one of three groups. Group one (n=26) received NTZ with Lactobacillus, group two (n=28) received NTZ along with a placebo, and the third control group (n=10) received the standard supportive care normally provided for Cryptosporidium spp. infections. RESULTS: No difference in the length of infection occurred in either NTZ treatment groups. Child anthropometric measurements were also not improved in the treated groups compared to controls. In conclusion, nitazoxanide did not reduce Cryptosporidium spp. disease duration irrespective of probiotic treatment nor did it result in any improvement in growth stunting in the infected children. IMPACT: The study findings helped to understand the role of probiotic, Lactobacillus reuteri DSM 17938 with Nitazoxanide treatment against cryptosporidiosis. In this study, we did not find any additive role of Lactobacillus reuteri DSM 17938 with Nitazoxanide treatment against cryptosporidiosis.