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Enteric pathogens and associated risk factors among under-five children with and without diarrhea in Wegera District,
Hailemariam Feleke1,2, Girmay Medhin3, Almaz Abebe4
1Ethiopian Institute of Water Resources, Addis Ababa University, Ethiopia.
Insights
Childhood diarrhea in Ethiopian slums is linked to Giardia and rotavirus infections. Interventions like vaccination and education are recommended to combat these prevalent enteropathogens.
Area of Science:
- Pediatric infectious diseases
- Public health in developing nations
- Microbiology of diarrheal diseases
Background:
- Childhood diarrhea is a significant health issue in developing countries, particularly in slum areas.
- The prevalence and etiological agents of diarrhea in these settings are often understudied.
- This research focuses on Ethiopian towns to address this knowledge gap.
Purpose of the Study:
- To determine the prevalence of Giardia, rotavirus, and bacterial enteropathogens in diarrheic and non-diarrheic children.
- To identify socio-environmental factors associated with childhood diarrhea.
- To investigate the specific roles of Giardia and rotavirus in diarrheal episodes.
Main Methods:
- A cross-sectional study was conducted in two Ethiopian towns.
- Stool samples were analyzed using microscopy (wet mounts for Giardia), culture (MacConkey agar for bacteria), and ELISA (for rotavirus).
- Data on diarrhea incidence and socio-environmental factors were collected through maternal interviews.
Main Results:
- Four enteropathogens (Giardia, rotavirus, Shigella, Salmonella) were identified in 31% of diarrheic and 12% of non-diarrheic children.
- Giardia prevalence was 21% in diarrheic vs. 8% in non-diarrheic children (p < 0.01).
- Rotavirus prevalence was 18% in diarrheic vs. 3.3% in unvaccinated non-diarrheic children (p < 0.01).
- Diarrheic children showed higher rates of bloody stool, vomiting, fever, and prolonged breastfeeding.
Conclusions:
- High prevalence of Giardia and rotavirus underscores the need for integrated healthcare strategies.
- Rotavirus vaccination and targeted educational interventions are recommended.
- Community-level health activities are crucial for controlling childhood diarrhea in the study area.
Introduction:
Childhood diarrhea is highly prevalent in slums in developing countries, but it remains understudied. The objectives of this study were to explore the prevalence of Giardia, rotavirus and bacterial enteropathogens among diarrheic and non-diarrheic children and investigate socio-environmental determinants of diarrhea in two Ethiopian towns.
Methods:
A cross-sectional study was conducted from June to October 2016. Prevalence of childhood diarrhea was established using information gathered during interviews with mothers/guardians. Saline wet mounts of fresh stool samples were used to test for the presence of Giardia. Stool samples were cultured on MacConkey agar and suspected colonies were characterized using biochemical tests. Susceptibility testing was done by the disk diffusion method. ELISA was used to screen for rotavirus.
Results:
A total of 225 children were included in this study. Four enteropathogens (Giardia, rotavirus, Shigella and Salmonella) were identified from 31% (35/112) diarrheic and 12% (14/113) from non-diarrheic children (p < 0.001). The prevalence of rotavirus infection was 18.0% among diarrheic children and 3.3% among non-diarrheic children unvaccinated against rotavirus (p < 0.01). The prevalence of Giardia was 21.0% among diarrheic and 8.0% among non-diarrheic children (p < 0.01). Diarrheic children had significantly higher rates of bloody stool (p < 0.02), vomiting, fever and breastfeeding for children beyond 23 months of age (p < 0.001). Giardia and rotavirus were identified in more diarrheic than non-diarrheic children.
Conclusion:
The high prevalence of Giardia and rotavirus in the study area indicates the need for coordinated healthcare activities in the two communities. Vaccination against rotavirus infections and educational interventions are recommended.
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