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From May to August 1999, we evaluated 401 patients from a pediatric hospital of Havana City. One group was composed of 113 patients with diarrhea admitted to the Gastroenterology ward and a second consisted of 288 patients without diarrhea, admitted for other reasons, and hospitalized within the same time period. Three stool samples were collected from each child and were examined using three parasitological techniques. When we compared the frequency of parasite species between both groups, we found Cryptosporidium spp. and Cyclospora cayetanensis, only in the group of children with diarrhea (P < 0.01). However, no significant differences were found in the occurrence of the other intestinal parasites (P > 0.05). In addition, in those children infected with Cryptosporidium, the diarrhea had a more prolonged duration (P < 0.01), while those infected with Cyclospora, the abdominal cramps or pain, and acute diarrhea were more frequently detected (P < 0.01). Our results showed that emerging intestinal coccidia are pathogens strongly associated in this group of children with diarrhea.

Introduction: In 1993, Cuba achieved leprosy elimination according to the World Health Organization's (WHO) indicator of less than one case per 10,000 population. Despite this achievement, detection of new cases occurs every year among all age groups including children. Detection of new cases in children reveals persistent transmission of the infection., Objective: To describe the clinical and epidemiological features of leprosy in individuals younger than 15 years (childhood leprosy) reported to the Cuban National Leprosy Control Program (NLCP) between 2012 and 2019., Methods: We conducted a retrospective descriptive study between 2012 and 2019 to assess the clinical and epidemiologic features of individuals under the age of 15 years with a confirmed diagnosis of leprosy reported to the NLCP. We reviewed the NLCP database and collected data to better define the total number of cases of leprosy in adults, children (younger than 15 years). We assessed socio-demographic variables (age, gender, and province of residence) as well as variables of clinical interest including operational classification and staging at diagnosis, bacillary index, grade of disability by WHO staging. Additionally, we evaluated epidemiological variables including passive versus active surveillance of cases, contact investigation focusing specifically in household transmission, and the degree of kinship as well as standing of the child within the focus of transmission when there were additional cases., Results: We identified fifty children during the study period corresponding to 3% of the overall cases of leprosy comprising all age groups in Cuba. In the age group younger than 15 years, the majorities of cases was from the Granma province and most were between the ages of 10 and 14 years. Clinically, multibacillary/lepromatous forms were the most common type identified with positive bacillary index. The majority of children diagnosed with leprosy during our study period had a history of a relative with a confirmed diagnosis of leprosy., Conclusions: Detection of cases of leprosy in individuals younger than 15 years of age in Cuba demonstrates ongoing transmission of M. leprae in specific geographic hotspots. Its frequency in the early adolescence, the predominant clinical forms, and the mode of detection associated with sources of suspected familiar infection demonstrated that there is a need for further efforts by the NLCP to conduct active surveillance activities among affected communities to identify cases of leprosy earlier with the goal of preventing further household and community transmission., Competing Interests: The authors have declared that no competing interests exist.

There are no meta-analyses specifically describing the prevalence of zoonotic and non-zoonotic genotypes of Giardia intestinalis in cats, which would be useful in defining the importance of cats as a source of zoonotic transmission. We performed a systematic review of the literature in three databases (PubMed, Scopus and SciELO) to assess the proportion of cats that were infected with specific G. intestinalis genotypes. A meta-analysis using a random effects model was performed to calculate the pooled prevalence and 95% confidence intervals (95%CI). A 2-tailed alpha level of 5% was used for hypothesis testing. Measures of heterogeneity, including Cochran's Q statistic, the I2 index, and the tau-squared test, were estimated and reported. Subgroup analyses were conducted by geographic area and animal origin, as well as coinfection. Publication bias was assessed using a funnel-plot. Up to November 1, 2015, the literature search yielded 780 articles, of which 29 studies were valid for analysis. The pooled prevalence rate was higher for genotype F (19 studies, n=368 cats) with 55.8% [95%CI (42.8%-68.7%), τ2=0.0463]. For genotype A (21 n=409) it was 38.7% [95%CI (29.0%-48.4%), τ2=0.0527], for genotype D (7, n=276) 8.9% [95%CI (2.1%-15.8%), τ2=0.0024], for genotype C (2, n=212) 3.1% [95%CI (2.5%-3.5%), τ2=0.0001], for genotype E (3, n=187) 2.9% [95%CI (0.0%-8.1%), τ2=0.0009], and for genotype B (4, n=230) it was 2.8% [95%CI (0.0%-5.7%), τ2=0.0002]. Genotypes A and B of G. intestinalis are present in a wide range of hosts, including humans and cats, whilst genotype E has been reported in bovines, ovines, caprine and porcine animals, as well as in dogs and cats; and genotype F is almost exclusive to cats. Thus genotypes A and B are the most important for zoonotic transmission. In this study, after genotype F (55.5%), genotype A yielded more than 38% in cats (95%CI 29-48). This has interesting possible implications in zoonotic transmission of giardiasis between cats and humans.