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Persisting symptoms after Cryptosporidium hominis outbreak: a 10-year follow-up from Östersund, Sweden
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0002-1216-2440
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0002-5203-9877
Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0002-5607-0118
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2023 (English)In: Parasitology Research, ISSN 0932-0113, E-ISSN 1432-1955, Vol. 122, no 7, p. 1631-1639Article in journal (Refereed) Published
Abstract [en]

In late 2010, an outbreak of Cryptosporidium hominis affected 27,000 inhabitants (45%) of Östersund, Sweden. Previous research shows that abdomen and joint symptoms commonly persist up to 5 years post-infection. It is unknown whether Cryptosporidium is associated with sequelae for a longer duration, how persisting symptoms present over time, and whether sequelae are associated with prolonged infection. In this prospective cohort study, a randomly selected cohort in Östersund was surveyed about cryptosporidiosis symptoms in 2011 (response rate 69.2%). A case was defined as a respondent reporting new diarrhoea episodes during the outbreak. Follow-up questionnaires were sent after 5 and 10 years. Logistic regressions were used to examine associations between case status and symptoms reported after 10 years, with results presented as adjusted odds ratios (aOR) with 95% confidence intervals. Consistency of symptoms and associations with case status and number of days with symptoms during outbreak were analysed using X 2 and Mann–Whitney U tests. The response rate after 10 years was 74% (n = 538). Case status was associated with reporting symptoms, with aOR of ~3 for abdominal symptoms and ~2 for joint symptoms. Cases were more likely to report consistent symptoms. Cases with consistent abdominal symptoms at follow-up reported 9.2 days with symptoms during the outbreak (SD 8.1), compared to 6.6 days (SD 6.1) for cases reporting varying or no symptoms (p = 0.003). We conclude that cryptosporidiosis was associated with an up to threefold risk for reporting symptoms 10 years post-infection. Consistent symptoms were associated with prolonged infection.

Place, publisher, year, edition, pages
Springer Nature, 2023. Vol. 122, no 7, p. 1631-1639
Keywords [en]
Cryptosporidium, Diarrhoea, Disease outbreaks, PI-IBS, Post-infectious symptoms, Sequelae
National Category
Infectious Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-209290DOI: 10.1007/s00436-023-07866-8ISI: 000990476700002PubMedID: 37199767Scopus ID: 2-s2.0-85159654199OAI: oai:DiVA.org:umu-209290DiVA, id: diva2:1764171
Funder
Region Jämtland Härjedalen, JLL-939404Region Jämtland Härjedalen, JLL-965542Region Jämtland Härjedalen, JLL-967794Region Jämtland Härjedalen, JLL-978075Region Jämtland Härjedalen, JLL-980156Visare Norr, 967799Available from: 2023-06-08 Created: 2023-06-08 Last updated: 2023-12-05Bibliographically approved

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Boks, MarijeLilja, MikaelWiderström, MicaelKarling, PontusLindam, AnnaSjöström, Malin

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