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喀麦隆西部大区 Dschang 区医院发热门诊患者细菌性胃肠炎的病因和危险因素:一项横断面研究。

Aetiology and risk factors of bacterial gastroenteritis among febrile outpatients at the Dschang District Hospital, West Region of Cameroon: a cross-sectional study.

机构信息

Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, West Region, Cameroon.

Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, West Region, Cameroon

出版信息

BMJ Open. 2021 Sep 13;11(9):e045965. doi: 10.1136/bmjopen-2020-045965.

Abstract

OBJECTIVES

To investigate the bacterial aetiologies and associated risk factors of gastroenteritis among typhoid suspected cases.

DESIGN

Cross-sectional study.

SETTING

This study was conducted at Dschang District Hospital of the Menoua Division, West Region of Cameroon, between April-November 2019 and June 2020.

PARTICIPANTS

Participants aged ≥2 years (mean 34±18.77 years) and of both sex suspected of having typhoid fever were included, while non-suspected typhoid cases were excluded. Self-reported sociodemographic and health information at recruitment was obtained from 556 participants.

METHODS

Collected stool samples were examined macroscopically and microscopically and subjected to culture. After culture, Gram staining was performed, followed by biochemical testing and characterisation using the Analytical Profile Index (API-20E) test kit.

INTERVENTIONS': No intervention was done during the period of study.

OUTCOME MEASURES

We identified bacterial causing gastroenteritis, and associated risk factors calculated using binary regression, adjusting for sociodemographic and health variables.

RESULTS

Of 556 patients, 74.28% tested positive for gastroenteritis. Among pathogens responsible for gastroenteritis, was found to be the main cause (21.1%), followed by (10.4%), (8.2%), (8.2%), (7.3%), whereas spp and were less represented among pathogens causing the disease among patients. A significant difference (p=0.002) was observed between abdominal pain and all the micro-organisms isolated from the patients. Patients having primary level of education were significantly associated (p=0.017; 3.163 (95% CI 1.228 to 8.147)) with the prevalence of gastroenteritis. Consumption of beverages (Wald statistic: 4.823; OR: 2.471; 95% CI (1.102 to 5.539); p=0.028), use of modern toilet (Wald statistic: 4.471; OR: 1.723; 95% CI (1.041 to 2.852); p=0.034) were strongly associated with gastroenteritis and rearing of bird (Wald statistic: 4.880; OR: 0.560; 95% CI (0.335 to 0.937); p=0.027), was found to be protective.

CONCLUSION

Acute bacterial gastroenteritis is a significant cause of morbidity in Dschang, with the prevalence of 74.28%. Many pathogens accounted for gastroenteritis, and (21.1%) could be a major cause, followed by (10.4%), (8.2%), (8.2%), (7.3%), whereas spp and were less represented. Gastroenteritis was highly associated with primary level of education, consumption of beverages, use of modern toilet while rearing of birds was unexpectedly found to be protective against Gastroenteritis. Further characterisation is planned.

摘要

目的

调查伤寒疑似病例中肠炎的细菌病因和相关危险因素。

设计

横断面研究。

地点

本研究于 2019 年 4 月至 11 月和 2020 年 6 月在喀麦隆西部曼努阿区的 Dschang 区医院进行。

参与者

纳入年龄≥2 岁(平均 34±18.77 岁)且疑似伤寒的患者,排除非疑似伤寒病例。从 556 名参与者中获得了自我报告的社会人口统计学和健康信息。

方法

采集粪便样本进行宏观和微观检查,并进行培养。培养后进行革兰氏染色,然后使用分析特征指数(API-20E)试剂盒进行生化检测和特征分析。

干预措施

在研究期间未进行任何干预。

结果

在 556 名患者中,74.28%的患者检测出肠炎阳性。在引起肠炎的病原体中,发现 是主要原因(21.1%),其次是 (10.4%)、 (8.2%)、 (8.2%)、 (7.3%),而 spp 和 在引起患者疾病的病原体中代表性较低。腹痛与从患者中分离出的所有微生物之间存在显著差异(p=0.002)。接受小学教育的患者与肠炎的患病率显著相关(p=0.017;3.163(95%CI 1.228 至 8.147))。饮用饮料(Wald 统计量:4.823;OR:2.471;95%CI(1.102 至 5.539);p=0.028)和使用现代厕所(Wald 统计量:4.471;OR:1.723;95%CI(1.041 至 2.852);p=0.034)与肠炎强烈相关,而饲养鸟类(Wald 统计量:4.880;OR:0.560;95%CI(0.335 至 0.937);p=0.027)则具有保护作用。

结论

急性细菌性肠炎是 Dschang 发病率的重要原因,患病率为 74.28%。许多病原体引起肠炎,而 (21.1%)可能是主要原因,其次是 (10.4%)、 (8.2%)、 (8.2%)、 (7.3%),而 spp 和 则较少见。肠炎与小学教育水平、饮用饮料、使用现代厕所高度相关,而饲养鸟类则出人意料地具有保护作用,可预防肠炎。计划进一步进行特征分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/667d/8438930/714e54ecb298/bmjopen-2020-045965f01.jpg

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