Gunsa Gorfu Geremew, Haddis Alemayehu, Ambelu Argaw
Department of Environmental Health Science and Technology, Jimma University, Jimma, Ethiopia
Department of Environmental Health Science and Technology, Jimma University, Jimma, Ethiopia.
BMJ Glob Health. 2024 Dec 27;9(12):e016694. doi: 10.1136/bmjgh-2024-016694.
In developing countries, due to improper management of domestic animals' exposures, under-five (U5) children have been affected by diarrhoea. However, there is no evidence that shows the presence of diarrhoea-causing pathogens in the faeces of U5 children and animals residing in the same houses in the Sidama region, Ethiopia.
A laboratory-based matched case-control study was conducted on children aged 6-48 months in the Sidama region of Ethiopia from February to June 2023. The study enrolled 113 cases, and 113 controls visited the selected health facilities during the study period. Faecal specimens from the case and control children and domestic animals were collected using transport media. Data were collected at children-residing homes by interviewing caretakers using the KoboCollect application. The presence of diarrhoea-causing pathogens (, non-typhoidal , and ) was detected using culture media, biochemical tests, gram stain, catalase and oxidase tests. The diarrhoea risk factors were identified using conditional logistic regressions and the random forest method using R.4.3.2.
Of the faecal specimens diagnosed, 250 (64.1%) tested positive for one or more pathogens. Faecal specimens from chickens tested more positive for and . Of the pairs of faecal specimens taken from case children and animals living in the same house, 104 (92%) tested positive for one or more similar pathogens. Among the factors, disposing of animal waste in an open field, storing drinking water in uncovered containers, caretakers poor knowledge about the animals' faeces as a risk factor for diarrhoea and ≤2 rooms in the living house were significantly associated with diarrhoea.
The finding shows that diarrhoea-causing pathogens are transmitted from domestic animals' faeces to children aged 6-48 months in the Sidama region. The improper management of animals' faeces and related factors were the predominant risk factors for diarrhoea.
在发展中国家,由于家畜接触管理不当,五岁以下儿童受到腹泻影响。然而,没有证据表明埃塞俄比亚锡达马地区居住在同一房屋内的五岁以下儿童和动物粪便中存在致腹泻病原体。
2023年2月至6月,在埃塞俄比亚锡达马地区对6至48个月大的儿童进行了一项基于实验室的配对病例对照研究。该研究招募了113例病例,113名对照在研究期间访问了选定的医疗机构。使用运送培养基收集病例和对照儿童以及家畜的粪便标本。通过使用KoboCollect应用程序采访看护人,在儿童居住的家中收集数据。使用培养基、生化试验、革兰氏染色、过氧化氢酶和氧化酶试验检测致腹泻病原体(非伤寒沙门氏菌、志贺氏菌和弯曲杆菌)的存在。使用条件逻辑回归和R.4.3.2的随机森林方法确定腹泻危险因素。
在诊断的粪便标本中,250份(64.1%)检测出一种或多种病原体呈阳性。鸡的粪便标本检测出非伤寒沙门氏菌和弯曲杆菌呈阳性的比例更高。在从居住在同一房屋内的病例儿童和动物采集的粪便标本对中,104份(92%)检测出一种或多种相似病原体呈阳性。在这些因素中,在露天处理动物粪便、将饮用水储存在无盖容器中、看护人对动物粪便作为腹泻危险因素的认识不足以及居住房屋内房间数≤2间与腹泻显著相关。
研究结果表明,致腹泻病原体在锡达马地区从家畜粪便传播至6至48个月大的儿童。动物粪便管理不当及相关因素是腹泻的主要危险因素。