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Table 1 Prevalence of Cryptosporidium and Giardia in African countries (2010–2016)

From: Cryptosporidium and Giardia in Africa: current and future challenges

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 [277279]
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, 289292]
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, 297300]
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, 302305]
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, 320323]
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 [333336]
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]
  1. 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