Prevalence and Distribution of Protozoan Enteropathogens in South Africa, 2016 to 2021

ABSTRACT

¹INGE KLEINHANS,
²TRISH WHITBREAD ,
³NEVASHAN GOVENDER ,
⁴BHAVANI MOODLEY ,
⁵CHARLOTTE SRIRUTTAN-NEL ,
⁶JOHN FREAN

¹DEPARTMENT OF COMMUNITY HEALTH / PUBLIC HEALTH MEDICINE
²Outbreak Response Unit, Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service
³Outbreak Response Unit, Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service
⁴Parasitology Reference Laboratory, Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases
⁵Parasitology Reference Laboratory, Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases
⁶Parasitology Reference Laboratory, Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases

Background

Background: Diarrhoeal diseases caused by viral, bacterial, or intestinal parasitic infections, such as Cryptosporidium spp., Entamoeba histolytica, and Giardia duodenalis (formerly known as G. intestinalis or G. lamblia), represent a significant global health concern, especially in low-income countries. They rank as the third leading cause of death among children under five, accounting for 1.7 billion cases and 443,832 deaths annually.
Objectives
To describe the prevalence and distribution of Cryptosporidium spp., E. histolytica, and G. duodenalis in the public health sector of South Africa from 2016 to 2021.

Method

A descriptive, retrospective, and cross-sectional analysis utilising secondary data obtained from the National Health Laboratory Service (NHLS) and the National Institute for Communicable Diseases (NICD) Surveillance Data Warehouse (SDW) was conducted.

Result

The test positivity rate for target parasites decreased during the study. Children under five had the highest prevalence of all three parasites. The Western Cape had the highest number of confirmed cases of E. histolytica and G. duodenalis, whereas Gauteng reported the most cases of Cryptosporidium. Cryptosporidium and E. histolytica were primarily found among females, while a higher number of males tested positive for G. duodenalis.

Conclusion

In South Africa, G. duodenalis was the most commonly detected protozoan enteropathogen among children under five. The overall prevalence of these parasitic protozoans remained below 1 per 100,000 population, indicating a lower disease burden than previously thought

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PRESENTING AUTHOR

Dr. Inge Kleinhans, MBChB, MPH

PUBLIC HEALTH MEDICINE REGISTRAR, Sefako Makgatho Health Sciences University

Dr Inge Kleinhans (MBChB, MPH) is a final-year Public Health Medicine registrar at Sefako Makgatho Health Sciences University, South Africa, with a strong academic background in Health Systems and Public Health Medicine. During her medical training, she was actively involved in public health initiatives and leadership roles, serving as Secretary and Vice President of JUPHASA and as President of the World Conference on Tobacco or Health (WCTOH) Youth Conference in 2018.

Dr Kleinhans has continued to demonstrate leadership throughout her career, most recently serving on the Colleges of Medicine of South Africa’s College of Public Health Medicine Subcommittee on Membership and Career Pathing. She currently holds several national roles, including Communications and Public Relations Lead for Women in Global Health South Africa, Scientific Committee Member of the South African Clinician Scientist Conference, and Executive Committee Member of the Safe Surgical Care Technical Working Group for South Africa.

She remains deeply committed to addressing the critical intersections of health, equity, and gender, leveraging her expertise to drive sustainable solutions in strengthening global health systems and policies.

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