Enteropathogens in Under-Five Children with Diarrhea in Health Facilities of Debre Berhan Town, North Shoa, Ethiopia

Abstract

BACKGROUND: Diarrheal disease is a major cause of mortality and morbidity for under-five children in Ethiopia. The purpose of this study was to investigate the behavioral and socioeconomic risk factors, etiology, and drug susceptibility of bacteria isolated from under-five children with acute diarrhea who were treated at Debre Berhan Referral Hospital or Health Center in Ethiopia.METHODS: A health facility based cross-sectional study design was used to investigate enteropathogens from 163 under-five children with acute diarrhea. After obtaining written consent from parents or guardians, data were collected using a standardized questionnaire. Freshly passed stool samples were collected for microbiological tests for bacteria and parasites. The chi-square test was used for assessing the relationships of variables.RESULTS: Enteropathogens were detected among 55.8% (91/163) participants. There was a 46%(75/163) bacterial culture positivity rate and a 9.8%(16/163) prevalence of parasites. The isolated enteropathogens were Escherchia coli, Klebsiella specie, Proteus species, Salmonella species, Shigella species, Enterobacter species, Giardia lamblia, Enteameba histolytica, Ascaris lumbricoides, Trichuris trichiura and Hymnoleps nana. Level of antimicrobial resistance of bacterial isolates ranged from 0 to 87.2%. Poor hand washing and poor cleaning of feeding utensils showed significant association with the presence of enteropathogens.CONCLUSION: Bacterial enteropathogens with drug resistance were observed in this study. Continuous health education and promotion about diarrheal disease for mothers/caretakers and regular surveillance of entropathogenes are recommended to reduce under-five mortality.

High diversity of Salmonella spp. from children with diarrhea, food, and environmental sources in Kilimanjaro – Tanzania: one health approach

“…Pathogens such rotavirus, adenovirus, Shigella and norovirus have been documented as the leading causes of diarrhea in the same study areas ( Hugho et al, 2023 ). Our findings are in line with similar findings in other studies in Tanzania ( Moyo et al, 2011 ) and Ethiopia and Iraq ( Harb et al, 2017 ; Zelelie et al, 2019 ), and the reported prevalence of Salmonella was low compared to studies conducted in other countries ( Azemi et al, 2013 ; Langendorf et al, 2015 ). This study identified six distinct STs from isolates obtained in diarrheal samples.…”

Prevalence, Risk Factors and Patterns of Different Underlying Enteropathogens in Pediatric Patients

“…According to the WHO, Africa and South-East Asia account for 78% of all diarrheal infant fatalities in poor countries. Poor environmental circumstances, socioeconomic level and behavioral characteristics are all substantially connected with the probability of transmission of diarrhea 1 . According to the onset and extent, diarrhea is classified into acute (<7 days), prolonged (7-14 days) and chronic (>14 days).…”

“…These are disseminated from the affected people through the oro-fecal route 5 . Parasitic infections associated with diarrhea include Ascaris lumbricoides; Giardia lamblia, Hymnolepis nana, Entamoeba histolytica, Cryptosporidium, Blastocystis hominis, Trichuris trichiura, and Cyclospora cayetanensis 1,6 . Rotavirus is the most prevalent viral cause of gastroenteritis associated with severe diarrhea, which kills 400,000 children per annum throughout the globe [7][8] .…”

Occurrence of Diarrheagenic Pathogens and Their Coinfection Profiles in Diarrheic Under Five Children and Tracked Human Contacts in Urban and Rural Settings of Eastern Ethiopia

“…However, majority of the studies conducted on diarrheagenic bacteria like; DEC, Salmonella, Shigella, and Campylobacter spp. in Ethiopia have reported only the pathogen prevalence in; diarrheic UFC 11,[19][20][21][22][23] or other age groups 24,25 and in asymptomatic food handlers in catering establishments and street food vendors 16,[26][27][28][29][30][31] as a separate entities. They do not focused on tracking of direct human contacts as source attributions for diarrhea diseases.…”

“…4 , 5 A study conducted in Hawassa and Debre Berhan indicated bacterial pathogens particularly Campylobacter , Shigella , and Salmonella spp. 10 and E. coli 11 are the main cause of childhood diarrhea accounting about 22.2% among the overall causative pathogens identified. The prevalence may be higher in eastern Ethiopia including Harar town and Kersa district where people have limited understanding of zoonotic disease and hand washings 12 , 13 and practicing open defecation.…”