Comparison of modified Ziehl Neelsen staining technique with antigen detection using ELISA in the diagnosis of Cryptosporidiosis at a tertiary hospital in North-Western Nigeria

Cryptosporidiosis is a diarrhoeal disease caused by Cryptosporidium species. It has become a more recognised pathogen especially in immunocompromised patients. It is an important opportunistic infection responsible for significant morbidity and mortality in Human Immunodeficiency Virus (HIV) and AIDS patients. The main aim of this study is to compare microscopy using modified Ziehl-Neelsen (MZN) with ELISA in the detection of Cryptosporidium in stool. The study was conducted at the HIV treatment clinic in Ahmadu Bello University Teaching hospital. It was a prospective and cross-sectional type. A total of 183 stool samples were collected and processed for the detection of the Cryptosporidium oocyst using modified Zeihl Neelsen stain and the antigen using ELISA. Kappa test was used which showed strong agreement between the two methods in the detection of Cryptosporidium in stool. Out of the 183 stool samples analysed, MZN stain identified 7 (3.8%) while ELISA identified 9 (4.9%) of the Cryptosporidia. The sensitivity, specificity, negative predictive value and positive predictive value of ELISA as compared to MZN for the detection of Cryptosporidium were 66.9, 99.4, 98.3 and 85.7%, respectively. This study showed that both MZN and ELISA can be used in the detection of Cryptosporidium in stool samples, even though ELISA had a higher specificity than MZN.