{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T03:49:04Z","timestamp":1780372144924,"version":"3.54.1"},"reference-count":38,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p><jats:italic>Cryptosporidium<\/jats:italic> spp. is a cause of diarrhea morbidity and mortality in children under 5 years of age. In addition, asymptomatic infections can have a negative impact on growth and development. In low- and middle-income countries where a greater number of infants may be malnourished, the results of treating cryptosporidiosis with the only Food and Drug Administration-approved drug nitazoxanide (NTZ) have been inconsistent. Malnutrition is both a risk factor for cryptosporidiosis and a consequence of infection with this parasite. Treatment with the probiotic <jats:italic>Lactobacillus reuteri<\/jats:italic> DSM 17938 has been shown to assist in nutritional recovery and the restoration of gut health. In this pilot randomized clinical trial, we examined whether combined probiotic and NTZ treatment could result in the reduction in parasitemia and infection-associated growth stunting in undernourished children. <jats:italic>Cryptosporidium<\/jats:italic> spp.-positive Bangladeshi children with a weight-for-length <jats:italic>Z<\/jats:italic> score between \u22121 and \u22123 were randomly assigned to one of three groups. Group 1 (<jats:italic>n<\/jats:italic> = 26) received NTZ and <jats:italic>Lactobacillus<\/jats:italic>, group 2 (<jats:italic>n<\/jats:italic> = 28) received NTZ along with a placebo, and the third control group (<jats:italic>n<\/jats:italic> = 10) received standard care. There was no difference in the duration of infection or improvement in child anthropometric measurements in any treatment group compared with control. Therefore, this pilot study does not provide support for treatment with NTZ, <jats:italic>Lactobacillus<\/jats:italic>, or the two in combination as an effective means of reducing the duration of <jats:italic>Cryptosporidium<\/jats:italic> spp. infection or improving growth in growth-stunted children.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0914","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T16:23:24Z","timestamp":1739291004000},"page":"733-739","source":"Crossref","is-referenced-by-count":7,"title":["Effect of Nitazoxanide and Probiotic Treatment on Bangladeshi Children with Cryptosporidiosis"],"prefix":"10.4269","volume":"112","author":[{"given":"Zannatun","family":"Noor","sequence":"first","affiliation":[{"name":"Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biplob","family":"Hossain","sequence":"additional","affiliation":[{"name":"Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishad Tasnim","family":"Mithila","sequence":"additional","affiliation":[{"name":"Nutrition Research Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amena","family":"Khatun","sequence":"additional","affiliation":[{"name":"Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sultan","family":"Mahmud","sequence":"additional","affiliation":[{"name":"Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleya","family":"Ferdous","sequence":"additional","affiliation":[{"name":"Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bipasha","family":"Akhter","sequence":"additional","affiliation":[{"name":"North South University Genome Research Institute, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masud","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Molecular Genetics and Microbiology, Vaccine Testing Center, University of Vermont, Burlington, Vermont;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A.","family":"Gilchrist","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashidul","family":"Haque","sequence":"additional","affiliation":[{"name":"Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Petri","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet Infect Dis","first-page":"85","article-title":"A review of the global burden, novel diagnostics, therapeutics, and vaccine targets for cryptosporidium","volume":"15","author":"Checkley","year":"2015"},{"key":"b2","series-title":"Lancet Glob Health","first-page":"e564","article-title":"Pathogen-specific burdens of community diarrhoea in developing countries: A multisite birth cohort study 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