Etiologies of diarrhea and drug susceptibility patterns of bacterial isolates among under-five year children in refugee camps in Gambella Region, Ethiopia: a case control study

Abstract

BackgroundDespite substantial global effort and updated clinical management guidelines, diarrhea continues to be among leading worldwide causes of morbidity and mortality in children. Infectious diarrhea, the most common form of diarrhea causes substantial morbidity and mortality among children in developing countries, and the muddled use of antibiotics needs caution due to potential problems of drug-resistance. The aim of this study is to identify etiologies of diarrhea and drug susceptibility patterns of bacterial isolates in under-five children in refugee camps in Gambella Region, Ethiopia.MethodsAn institution- based matched case control study was conducted using a questionnaire-based interview from June to December 2017 in Pugnido and Teirkidi refugee camps. Stool samples were collected and parasites causing diarrhea were identified by wet mount microscopy. Conventional culture supplemented with API 20E identification kit was used to identify Salmonella and Shigella species. Antibiotic susceptibility of bacterial isolates was investigated by using the disk diffusion method. The association between etiologies and diarrhea was analyzed using McNemar test or Fisher exact test with 95% confidence interval at a level of significance of P < 0.05.ResultsThe overall prevalence of enteric pathogens were 55 (41.0%) in diarrhea cases and 18 (13.4%) in healthy controls. The detected etiologies include Giardia lambia (28), Shigella spp. (16), E. hystolyotica/dispar (13), Ascaris lumbricoides (10), Salmonella spp. (6), Cryptosporidium parvum (6), Hymenolepis nana (4) and Isospora belli (3). All isolates were sensitive to kanamycine and ceftazidime. The high resistance rate was observed against ampicillin (100%), amoxicillin (100%), erythromycin (52%), chloramphenicol (47.5%), tetracycline (40.5%), cotrimoxazole (34.8%) and amoxicillin-clavulanic acid (33%). The majorities of the isolates had a low rate of resistance to ciprofloxacin (8.7%), naldxic acid (8.7%) and amikacin (13%).ConclusionsGiardia lamblia, E. Hystolytica/dispar, and Shigella spp are the common etiologies of diarrhea in children in the studied refugee camps. The study also showed that significant numbers of bacterial isolates were resistant to the commonly used antimicrobial drugs. Therefore, improving clinical laboratory services and promoting evidence-based drug prescription may reinforce proper use of antibiotics and reduce the emergence of microbial resistance.

COVID-19 pandemic and economic cost; impact on forcibly displaced people

“…There are chances that UNHCR will face a drop in funds. This will further worsen the situation for these displaced people including 37 million children living in these camps [5,6]. World has to act smartly in order to prevent another human crisis in coming months.…”

“…World has to act smartly in order to prevent another human crisis in coming months. Periodic diarrhea, malaria and polio cases had been reported from these refugee settlements in the past [6]. It is high time for global community to act swiftly to save these lives.…”

Identification of Bacteria Causing Diarrhea in Under-Fives Children Using Culture Methods in Bima, Indonesia

“…were detected in 28 (18.80%) stool samples. In the research conducted by Mekonnen, Mengistie, Sahilu, Kloos, & Mulat (2019), 10.50% shigella bacteria were found from a total of 134 samples examined. In another study, 7% were infected with Shigella bacteria (Zhu et al, 2016), and in Ghana, there were 5.60% positive Shigella from 347 samples examined (Ashie et al, 2017).…”

The in vitro Effects of the Probiotic Strain, Lactobacillus casei ZX633 on Gut Microbiota Composition in Infants With Diarrhea

“…Moreover, there is evidence that microbes at one site can affect the host at other sites, and interesting discoveries on gut microbial community linked with the milieu of the brain, respiratory and urogenital tracts, heart and skin, resulting in that microbial community might be new approaches to health maintenance, disease prevention and even treatment (Reid et al, 2017 ). Diarrhea is related to an imbalance in the gut microbiota, such as the presence of specific pathogens like Clostridium (Mallina et al, 2018 ), Salmonella (Tadesse, 2014 ), and Escherichia (Chingwaru and Vidmar, 2017 ; Mekonnen et al, 2019 ). Given the potential resistance effects of some antibiotic therapies for bacterial diarrhea, studies have suggested that probiotics could be an effective strategies in combatting these diarrheal diseases (Szajewska et al, 2011 ; Hojsak et al, 2018 ).…”