Zelelie Tizazu Zenebe, Gebreyes Demissew Shenkute, Tilahun Alemnesh Tesema, Craddock Hillary A, Gishen Nigus Zegeye
Department of Medicine, Medical Microbiology Unit, Debre Berhan University, Ethiopia.
Department of Medicine, Medical Laboratory Unit, Debre Berhan University, Ethiopia.
Ethiop J Health Sci. 2019 Mar;29(2):203-214. doi: 10.4314/ejhs.v29i2.7.
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.
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.
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.
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.
腹泻病是埃塞俄比亚五岁以下儿童死亡和发病的主要原因。本研究的目的是调查在埃塞俄比亚德布雷伯汉转诊医院或健康中心接受治疗的五岁以下急性腹泻儿童分离出的细菌的行为和社会经济风险因素、病因及药敏情况。
采用基于医疗机构的横断面研究设计,对163名五岁以下急性腹泻儿童的肠道病原体进行调查。在获得家长或监护人的书面同意后,使用标准化问卷收集数据。采集新鲜粪便样本进行细菌和寄生虫的微生物检测。采用卡方检验评估变量之间的关系。
55.8%(91/163)的参与者检测出肠道病原体。细菌培养阳性率为46%(75/163),寄生虫感染率为9.8%(16/163)。分离出的肠道病原体有大肠杆菌、克雷伯菌属、变形杆菌属、沙门菌属、志贺菌属、肠杆菌属、蓝氏贾第鞭毛虫、溶组织内阿米巴、蛔虫、鞭虫和微小膜壳绦虫。细菌分离株的抗菌耐药水平在0至87.2%之间。洗手习惯差和喂养用具清洁不佳与肠道病原体的存在显著相关。
本研究中观察到具有耐药性的细菌性肠道病原体。建议对母亲/照顾者持续开展腹泻病健康教育和宣传,并定期监测肠道病原体,以降低五岁以下儿童死亡率。