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Background  In Mozambique, infection by intestinal parasites is reported all over the country. However, infection in children with diarrhoea is mostly focused in the southern region of Mozambique. This work aims to determine the frequency and potential risk factors for infection by  Cryptosporidium  spp.,  Giardia lamblia,  and  Entamoeba histolytica  in children under-five years hospitalized with diarrhoea in  Hospital Central de Nampula , northern Mozambique.    Methods  A cross-sectional hospital-based surveillance was conducted between March 2015 and January 2018 in children admitted with diarrhoea in  Hospital Central de Nampula . Sociodemographic information was obtained through semi-structured interviews applied to the children’s caregivers. A single stool sample was collected from each child to detect antigens from  Cryptosporidium  spp.,  G. lamblia,  and  E. histolytica  using an immune-enzymatic technique. Crude and adjusted odds ratios (with 95% Confidence Intervals) were obtained by logistic regression models to identify factors associated with infection by  Cryptosporidium  spp. and  G. lamblia .    Results  The median age and interquartile intervals of our sample population was 12 months (8–20). Intestinal protozoa were detected in 21.4% (59/276).  Cryptosporidium  spp. was the most common protozoa (13.9% - 38/274), followed by  G. lamblia  (9.1% - 25/274) and  E. histolytica  (0.4% - 1/275). Children with illiterate caregiver’s ( p -value = 0.042) and undernourished ( p -value = 0.011) were more likely to be infected by  Cryptosporidium  spp.  G. lamblia  was more common in children living in households with more than four members (p-value = 0.039).  E. histolytica  was detected in an eleven month’s child, co-infected with  Cryptosporidium  spp. and undernourished.    Conclusion   Cryptosporidium  spp. and  Giardia lamblia  were the most common pathogenic intestinal protozoa detected in children with diarrhoea hospitalized in the  Hospital Central de Nampula . Our findings obtained highlight the importance of exploring the caregiver’s education level, children’s nutritional status for infections with  Cryptosporidium  spp., and living conditions, namely crowded households for infections with  G. lamblia  in children younger than five years.

bmc infectious diseases

Intestinal protozoa in hospitalized under-five children with diarrhoea in Nampula – a cross-sectional analysis in a low-income setting in northern Mozambique