Microbial pathogens associated with acute childhood diarrhoea in Kumasi, Ghana

Abstract

BackgroundDiarrhoeal diseases are among the most frequent causes of morbidity and mortality in children worldwide, especially in sub-Saharan Africa. This case–control study was conducted to investigate the bacterial, viral and parasitic pathogens associated with acute diarrhoea among children attending three health facilities in Kumasi, Ghana.MethodsStool specimens were collected from 240 children under 5 years of age visiting hospitals in Kumasi, Ghana due to acute diarrhoea and from 107 healthy controls of similar age. Both intestinal and malaria parasites were diagnosed by microscopy whereas rota- and adenoviruses were identified by stool antigen immunochromatograhic testing. Bacterial enteropathogens were detected by conventional culture techniques.ResultsOf all subjects, 23 (6.6%) were positive for malaria parasitaemia, 139 (40.1%) had at least one bacterial agent in their stool and 25 (7.2%) had ova or parasites. Subjects infected with malaria had the highest odds of having diarrhoea [12.0 (95% CI 1.56, 92.35)] followed by those with rotaviruses [4.4 (95% CI 2.05, 9.47)] and bacterial infection [4.99 (95% CI 1.45, 17.17)].ConclusionIn conclusion, this study was unique as it looked at the three groups of pathogens (parasites, viruses and bacteria) that cause acute diarrhoea in children in the Kumasi metropolis of Ghana. This study has shown for the first time since 2004 that malaria parasitaemia, rotavirus and bacterial infections still remain common pathogens associated with acute childhood diarrhoea in the Kumasi metropolis of Ghana.

Etiology and pathogenicity of bacterial isolates: a cross sectional study among diarrheal children below five years in central regions of Kenya

“…Probably this observation where previously known major sero-groups that caused infection are been overtaken and the less common sero-groups as observed from our study takes the lead. Our finding closely matches to a greater extent the work reported recently in Ghana [41] that Shigella species were generally more common isolates in children below 2 years. Dysentery outbreaks are common especially in developing countries where hygiene and sanitation are questionable.…”

“…Isolation of Salmonella in children above one year and older children above 2 years in our study suggests that the bacteria is less likely to cause infantile diarrhea harmonizing fairly with finding of a study that observed Salmonella infection was more likely to occur as the child's age progressed [38]. More than half of the Salmonella infections were noted to fall within those aged 13-24 months which conforms with a study done in Lusaka Zambia [40] but sharply contradicts finding of a study in Kumasi Ghana that observed those aged 13-24 months were the least infected (1.5%) while those aged 25-60 months were the most infected [41]. Other than probable food/water-borne Salmonella transmission that may occur during complementary feeding, another possible reason of the data observed that more salmonella infections occurred above one year could be that children of older age interact with domesticated animals such as chicken and other fowl within the households as most participants were drawn from rural and semi-urban areas.…”

Improved Detection of <i>Shigella</i> Species in Diarrheic Children in Ghana Using Invasion Plasmid Antigen H-based Polymerase Chain Reaction Technique

“…Diagnosis of bacterial diseases by conventional culture method usually takes days or weeks after sampling and is not always successful. The overall detection of Shigella in 31.2% of diarrheal cases by ipaH-based PCR in this study is higher than what was reported in Ghana previously [9][10]. PCR has the ability to rapidly identify specific pathogens that are difficult to culture in vitro or require a long cultivation period.…”

“…Previous burden of disease studies in Ghana using traditional culture method documented low prevalence of Shigella in stool samples [9][10]. Diagnosis of bacterial diseases by conventional culture method usually takes days or weeks after sampling and is not always successful.…”

“…This study was under the STOPENTERICS FP7 programme which aimed to provide novel prophylactic solutions by imposing a two-fold paradigm switch in the development of vaccine candidates against Shigella and ETEC. Most of the previous research on Shigella in Ghana involved conventional culture method of isolating the bacteria [9][10] resulting probably in underestimated prevalence. As global efforts are geared towards the introduction of vaccines against Shigella and Enterotoxigenic Escherichia coli (ETEC) [11], this study sought to establish Shigella burden of disease in children <5 years of age for the implementation of appropriate interventions to control diarrheal disease in Ghana.…”