Background
Better knowledge of endogenous germs and their associated demographic and environmental risk factors in a locality are essential to treat childhood diarrheal diseases. The aim of the study was to identify and characterize bacterial and parasitic pathogens responsible for childhood diarrhea, and to identify environmental risk factors associated with diarrhea in children under 5 years old living in Koula-Moutou, East-Central Gabon.
Methods
A cross-sectional study was performed from May 2016 to February 2018. One-hundred and thirty-two (132) children under 5 years old were enrolled. The detection of pathogens in stool samples was performed using microscopic examination and MIF concentration for parasites, and conventional culture on selective media for enterobacteria.
Results
The prevalence of diarrheal pathogens was 46.1%, including bacterial enteropathogens (25.5%) and parasites (20.6%). A total of 228 pathogenic organisms were isolated, including 199 bacterial strains (87.3%) and 29 parasites (12.7%). The specific richness of the isolated enterobacteria was 24 species with a high prevalence of E. coli (39.8%), including 26.7% for the diarrheal cases and 13.1% for the controls. Twelve (12) parasite species were also isolated and the most common types of parasites were rhizopods (44.8%), which accounted for 37.9% of the diarrheal cases and 6.9% of the controls. Univariate analysis showed that the presence of watercourses (OR = 3.37) and domestic animals (OR = 1.65) were significant risk factors for diarrhea.
Conclusion
The findings show a high prevalence of bacterial enteropathogens but a low rate of parasites and bacteria-parasite co-infection in the study area. Risk factors associated with diarrhea among children under 5 years old were the presence of watercourses and domestic animals. These findings highlight the need to strengthen the routine examination of diarrheic stool samples for the diagnosis of pathogenic organisms. Further analyses are required to better understand the etiologies and risk factors associated with the transmission of bacteria and parasites in rural, semi-urban and urban regions of Gabon.