Prevalence of paediatric diarrhoea in Arba minch government health institutions, Southern Ethiopia and associated factors

Abstract

Infectious diarrhoea is one of the leading causes of paediatric morbidity and mortality in developing countries like Ethiopia; several factors contribute to the worsening of condition. This study was aimed to determine the prevalence and associated factors of enteropathogens, and antimicrobial susceptibility patterns of enterobacteria among paediatric patients attending four selected government health institutions in Arba Minch, southern Ethiopia. The study materials were stool samples collected from 367 paediatric patients with acute diarrhoea, which were then inoculated onto MacConkey agar, xylose lysine deoxycholate agar, and Campylobacter selective media for the isolation of enteric bacteria. Catalase, oxidase, indole, hydrogen sulfide, citrate, urease, and carbohydrate fermentation tests were performed for the phenotypic identification of the recovered isolates. The antibiotic susceptibilities of enterobacteria were determined via the Kirby-Bauer disc diffusion method. The wet mount and formol-ether concentration techniques were also used to identify enteroparasites. Descriptive and inferential statistical analyses were done using SPSS, and P-values ≤ 0.05 were considered statistically significant. Among 367 paediatric patients, 39.8% (n = 146) were tested positive for any one of the entero-pathogens, constituting 37.6% (n = 138) entero-parasites and the rest 2.2% (n = 8) corresponded to enterobacteria; Giardia lamblia (17.9%, n = 66) and Entamoeba histolytica (14.4%, n = 42) were predominant among the former; Shigella dysenteriae (1.1%, n = 4), followed by Salmonella Typhimurium and Campylobacter jejuni/coli (0.55%, n = 2 each), were the dominant bacteria. Invariably, all isolates were 100% susceptible to ciprofloxacin. The occurrence of bloody diarrhoea [(AOR = 3.01, 95% CI (1.65-5.48)] and having illiterate parents [(AOR = 5.46, 95% CI (1.79-16.66)] were found to be statistically associated with the enteric infection. More than a fourth of the paediatric patients in the cohort were affected by enteropathogens; intestinal protozoans were the predominant group, highlighting a significant health concern that demands immediate attention. Besides, edifying the parents of paediatric patients about personal hygiene and sanitation practices would be the most important intervention strategy to emphasise.

Keywords: Arba minch; Diarrhoea; Enteroparasites; Enteropathogens; Paediatrics.