Microsporidial Infection and Associated Risk Factors Among Pediatric Renal Patients

Abstract

<title>Abstract</title> Microsporidia are intracellular parasites with a worldwide distribution, known to opportunistically infect immunocompromised individuals. This study aimed to investigate microsporidial infection and associated risk factors among pediatric renal patients. <bold>Methods</bold> :A total of 90 children were included in the study: 30 with chronic kidney disease (CKD), 30 undergoing hemodialysis (HD), and 30 apparently healthy children. Enzyme-linked immunosorbent assay was used for serologic detection of anti-microsporidia antibodies. Modified trichrome staining (MTS) was applied for the detection of microsporidia spores in urine and stool samples. PCR was used to detect microsporidia DNA in blood samples. The Association of infection with different variables was evaluated using univariate and multivariate statistical analysis. <bold>Results</bold> : Anti-microsporidia antibodies were detected in 46.7% of participants, with a significantly higher seropositivity among HD (83.3%) compared to CKD patients (36.7%) and the control group (36.7%) (p &lt; 0.0001). The duration of dialysis was significantly longer in seropositive patients (p &lt; 0.001). Fecal spores were detected in 42.2% of children with no statistically significant difference between groups. A fair agreement was observed between serological and stool-based diagnostic methods. Examination of urine samples and PCR on blood samples yielded negative results. The child’s gender, place of residence, source of drinking water, and animal contact were identified as independent risk factors for microsporidial infection. <bold>Conclusion</bold> : Microsporidial infection is highly prevalent in the study population. HD and several demographic and environmental factors favor its spread. These findings highlight the need for further epidemiological studies to support preventive strategies. Given the diagnostic complexity, a combination of complementary methods is recommended to ensure accurate detection.