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Microsporidian Infection Is Prevalent in Healthy People in Cameroon

Department of Biological Sciences, University of Cincinnati, Cincinnati, Ohio,¹ Faculty of Medicine and Biomedical Sciences, University of Yaoundé-1, Yaoundé, Cameroon,² Tulane National Primate Research Center, Covington, Louisiana³

Received 9 February 2007/ Returned for modification 11 April 2007/ Accepted 25 June 2007

Most studies of opportunistic infections focus on those with weak immune systems, such as human immunodeficiency virus (HIV)/AIDS patients and children. However, there is a lack of information on these infectious agents in healthy people worldwide. In the present study, stool samples from both HIV patients and healthy people were examined to begin filling in this serious gap in the understanding of human microsporidiosis, particularly the enteric parasite Enterocytozoon bieneusi. Specimens were obtained from 191 individuals living in Yaoundé, the capital city of Cameroon, in sub-Sahara Africa, including 28 HIV-positive patients who also had tuberculosis (TB). E. bieneusi prevalence was 35.7% among the HIV⁺ TB patients, whereas it was only 24.0% among 25 HIV^– TB patients in the same hospital. Unexpectedly, the prevalence (67.5%) of microsporidiosis was found to be even higher for 126 immunocompetent individuals than for those with TB (healthy people compared to HIV⁺ TB and HIV^– TB patients; P < 0.001). The immunocompetent group included people ranging from 2 to 70 years of age living in four different neighborhoods in Yaoundé. The highest prevalence (81.5%) was among teenagers, and the highest mean infection score (+2.5) was among children. Additional studies of immunocompetent people in other parts of Cameroon, as well as in other countries, are needed to better understand microsporidiosis epidemiology. There is still much more to be learned about the natural history of microsporidia, the pathogenicity of different strains, and the role of enteric microsporidia as opportunistic infections in immunodeficient people.

Published ahead of print on 3 July 2007.