Bloody diarrhoea cases caused by Shigella and amoeba in Jordan

This study was done to evaluate the occurrence of bloody diarrhoea in Jordan in the period 1988-2000, with particular interest in Shigilla and amoeba cases in relation to the surveillance control system and hygiene policy. The cases were collected from various medical diagnostic laboratories. In addition to the clinical presentation, stool specimens or rectal swabs were collected and sub-cultured on the appropriate media. Shigella spp. and amoeba were identified using standard methods. Anti-microbial susceptibility tests were performed. One-way ANOVA and Least Significant Difference (LSD) were used for statistical analysis. The number of stool specimens tested for bloody diarrhoea was 34,529 in the study period. Positive stool samples were reported in 711 (2.1%) patients. Out of these 55% were males and 45 % were females. The highest number of cases 96 (13.5%) was reported in the year 1999. The highest incidence rate was (20.6) in the year 1996 and the lowest incidence rate (8.9) was in the year 2000. The highest number of cases during the period 1998-1992 was among age group 1-4 year. During the year 1993-1996 the highest number of cases was among group 5-14 year. The highest number of cases during the year 1997-2000 was among age group 15-24 year. There was a significant variation between numbers of bloody diarrhoeal cases and age groups (P < 0.001) as well as sex (P = 0.028). No significant variation (P = 0.06) was observed between number of bloody diarrhoea cases and seasons or months. The number of stool specimens tested for amoebiasis during the study period 1994-2000 was 229,040. Shigella was isolated from 304(0.13%) cases and amoeba was found in 24,211(10.6%) cases. The lowest incidence rate in bloody diarrhoeal cases in the year 2000 indicates good quality hygienic control. The increased resistance of Shigella to antibiotics may produce a future problem, which might require a further prescribing policy for treatment.