Comparative Performance of Microscopy and Nested PCR for the Detection of Cryptosporidium Species in Patients Living with HIV/AIDS in Abidjan (Côte d’Ivoire)

Cryptosporidium spp. infection is one of the causes of diarrhea in people living with HIV/AIDS. The objective of this study is to compare the sensitivity of microscopy and molecular biology to determine the prevalence of Cryptosporidium spp. in Patients Living With HIV (PLWH). This is a descriptive cross-sectional study conducted in three care centers for people living with HIV/AIDS in Abidjan. It took place from November 2018 to March 2020. Sociodemographic data were obtained via a questionnaire. Stool and blood samples were collected and analyzed for microscopy and Nested PCR detection of Cryptosporidium spp. Blood samples were analyzed for CD4+ count. A total of 363 stool samples were collected from the three sites. Individuals aged 40 - 50 years (36.52%) were most likely to participate in the study. HIV Type 1 accounted for 86.22% of the study population. The samples collected consisted of 47.65% diarrheal stool. Microscopic examination of the stool yielded a prevalence of 3.86% for Cryptosporidium spp. while the prevalence was 3.96% with molecular identification. No statistically significant difference was observed between these two prevalences (χ2 = 0.26;p = 0.609). CD4+ count was the factor associated with Cryptosporidium spp. infection for both microscopy (OR = 0.887, p = 0.001) and PCR (OR = 0.896, p = 0.001). This study demonstrated that Nested PCR improves the detection of Cryptosporidium spp. in patient diagnosis.