ENTERIC PATHOGENIC BACTERIA AND ASSOCIATED RISK FACTORS IN DIARRHOEIC AND DYSENTERIC CHILDREN IN SOKOTO STATE, NIGERIA
ENTERIC PATHOGENIC BACTERIA AND ASSOCIATED RISK FACTORS IN DIARRHOEIC AND DYSENTERIC CHILDREN IN SOKOTO STATE, NIGERIA
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Date
2016-10
Authors
NUHU, Abdulrazak
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Abstract
Enteric bacterial diarrhoeal and dysenteric illnesses exact a heavy toll on human populations, particularly children. Diarrhoea due to bacterial infections is an important cause of morbility and mortality in infants and young children in most developing countries. Diarrhoea a situation when a person passes more stool than is normal, passing three or more loose or liquid stools per day is caused by a variety of pathogens including bacteria, viruses, and parasites. Among the bacteria, Campylobacter jejuni, Salmonella, Shigella and Yersinia species are known to be the most common and economically important agents but other bacteria, including diarrhoeagenic Escherichia coli (DEC) and Campylobacter coli have also been identified as causes of enteric diarrhoeal disease in children. The aim of this study is to detect enteric bacterial pathogens and associated risk factors in diarrhoeic children in Sokoto state, Nigeria. A total of four hundred and twenty diarrhoeic children five years and less from the three senatorial zones of Sokoto State, Nigeria were screened for the presence of enteropathogenic bacteria namely Escherichia coli, Campylobacter, Salmonella and Shigella species. Stool samples were analyzed by both the conventional culture methods and the standard PCR techniques for the detection of the target enteropathogenic bacterial virulence genes. The antibiogram of the isolates were determined by disk diffusion method. To determine some risk factors associated with incidence of bacterial diarrhoea in children structured questionnaire designed to obtain basic data was used while various water sample from the study area were examine for possible faecal contamination. Of the diarrhoeaic stool specimens analyzed by the culture techniques, Campylobacter species, Escherichia coli, Salmonella enterica and Shigella species were detected in 14 (3.3%), 79 (18.8%), 30 (7%) and 17 (4%) of cases respectively. On the other hand, results of PCR of the stool specimens revealed that, Campylobacter spp., E. coli, Salmonella enterica and Shigella
spp. accounted for 34 (8.1%), 87 (20.7%), 35 (8.3%) and 22 (4.8%) of all cases of childhood diarrhoea respectively. E. coli remains the major cause of infantile diarrhoea, followed by Salmonella enterica irrespective of the method of stool analysis. It was observed that, the incidences of diarrhoea among children of 0 to 5 years across the study area is higher (19 - 21 %) among children within the 0 to 3 years age bracket compared with the 13 – 15% recorded for children of 4 - 5 years age bracket. Also, a consistent trend of decreasing incidence with increasing age of the children was noted across the study area. Children of both sexes appear to be equally affected by the disease (51.4% males, 48.6% females). The antibiogram studies on the isolates revealed that most were resistant to Amoxycillin-clavulanic acid, Cotrimaxazole and Erythromycin. However the isolates were found highly susceptible to Ofloxacin, Ciprofloxacin, Ceftriaxone and Cefuraxime. The multiple antibiotics index analysis revealed that all the four isolates had a very high index value (≥0.2%). The percentage frequency of multiple antibiotics resistance (MAR) index value greater than 0.2%, were recorded as 8(57.1%), 44(55.7%), 19(63.3%) and 10(58.8%) isolates for Campylobacter species, Escherichia coli, Salmonella enterica and Shigella species respectively. The risk factors so far identified are lack of portable safe water, improper sewage disposal system and poor hygienic practices. Assessement of various potential risk factors, the incidence of diarrhoea and infection rate indicated that strong association exist and the difference observed was considered statistically significant (P<0.05
Description
A THESIS SUBMITTED TO THE SCHOOL OF POSTGRADUATE STUDIES, AHMADU BELLO UNIVERSITY
IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF DOCTOR OF PHILOSOPHY OF SCIENCE IN MICROBIOLOGY
DEPARTMENT OF MICROBIOLOGY,
FACULTY OF SCIENCE
AHMADU BELLO UNIVERSITY,
ZARIA, NIGERIA
Keywords
ENTERIC PATHOGENIC BACTERIA,, ASSOCIATED RISK FACTORS,, DIARRHOEIC,, DYSENTERIC CHILDREN,, SOKOTO STATE,, NIGERIA