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Epidemiological study on infectious diarrheal diseases in children in a coastal rural area of Kenya
S M Saidi1, Y Iijima, W K Sang
1Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi.
Insights
Diarrheal diseases in Kenyan children are primarily caused by bacteria like E. coli and parasites. Contaminated drinking water and poor hygiene are key infection routes, highlighting the need for health education to control diarrhea.
Area of Science:
- Pediatrics
- Infectious Diseases
- Environmental Health
Background:
- Diarrheal diseases pose a significant threat to child health in developing nations.
- Understanding the specific pathogens and transmission routes is crucial for effective intervention.
Purpose of the Study:
- To identify the causative agents of diarrhea in children under five in rural Kenya.
- To investigate the correlation between environmental factors and diarrheal disease incidence.
Main Methods:
- Analyzed stool samples from 862 pediatric patients presenting with diarrhea.
- Identified bacterial, parasitic, and viral pathogens.
- Assessed drinking water contamination and correlated with rainfall and patient numbers.
Main Results:
- Bacterial pathogens, particularly diarrheagenic Escherichia coli (13.8%), Salmonella spp. (7.3%), and Shigella spp. (6.5%), were common.
- Intestinal parasites (12.6%) and rotavirus (16.1% of tested) were also identified.
- High levels of bacterial and coliform contamination were found in 98% and 72% of household drinking water, respectively.
Conclusions:
- Contaminated drinking water and fecal-oral transmission are likely primary infection routes for childhood diarrhea.
- Enhancing hygiene practices through health education is a feasible and recommended control strategy.
Abstract:
Diarrheal diseases are major causes of morbidity and mortality among children in developing countries. We have analyzed the causative agents of diarrhea in children under five years of age who resided in rural environments but attended a hospital in Malindi, a coastal town in Kenya. Bacterial diarrhea was found in 239 (27.7%) of 862 patients with diarrhea. Diarrheagenic Escherichia coli, including enteropathogenic, enterotoxigenic, and enterohaemorrhagic strains, was isolated from 119 (13.8%) patients, followed by Salmonella spp. (63 cases, 7.3%) and Shigella spp. (56 cases, 6.5%). Intestinal parasites were found in 109 (12.6%) of the patients. Entamoeba histolytica and Giardia lamblia were found in 67 (7.8%) and 42 (4.9%) of the cases, respectively. Rotavirus was found in 69 (16.1%) of 428 cases, a part of the 862 cases. Significant differences in age distribution were seen in diarrheal cases due to Campylobacter spp., G. lamblia, and rotavirus. No significant seasonal incidence of specific pathogens was found, but the number of diarrheal patients was significantly correlated to rainfall. Drinking water was contaminated with bacteria at concentrations ranging from 10(3) to 10(6) CFU/ml in 98% of the households and by coliform bacteria at concentrations of 10(2) to 10(5) CFU/ml in 72% of the households. These results suggest that the main routes of infection may be contaminated drinking water and fecal-oral transmission of enteric pathogens. Consequently, we propose that the enhancement of hygienic practice through health education is a feasible control measure of diarrhea in the study area.