Aetiology and factors associated with bacterial diarrhoeal diseases amongst urban refugee children in Eastleigh, Kenya: A case control study

Abstract

IntroductionKenya is home to over 400 000 refugees from neighbouring countries. There is scanty information about diarrhoea amongst urban refugees in Kenya.ObjectivesWe investigated the enteric bacteria causing diarrhoea amongst urban refugee children and described the associated factors.MethodDuring the period of August–December 2010, urban refugee children between the ages of two and five who attended Eastleigh County Council Health Centre were enrolled into the study. Diarrhoeal cases were compared with age-matched children with no diarrhoea (controls). Stool specimens were collected and enteric bacteria isolated. A questionnaire was administered to identify risk factors.ResultsA total of 41 cases and 41 controls were enrolled in the study. The age and country of origin were similar for cases and controls. The bacterial isolation rates amongst the cases were: non-pathogenic Escherichia coli 71%, Shigella dysenteriae 2.4%, Shigella flexneri 2.4%, Salmonella paratyphi 5%. For the controls, non-pathogenic E. coli 90% and enterotoxigenic E. coli (ETEC) 2.4% were amongst the organisms isolated. All isolates were resistant to amoxicillin; resistance to other antibiotics varied by isolate type. Factors associated independently with diarrhoea included children not washing their hands with soap (aOR 5.9, p < 0.05), neighbour(s) having diarrhoea (aOR 39.8, p < 0.05), children not exclusively breastfed for their first 6 months (aOR 7.6, p < 0.05) and children eating food cooked the previous day (aOR 23.8, p = 0.002).ConclusionsShigella species, Salmonella species and ETEC were found to be responsible for diarrhoea amongst the urban refugee children. Measures to control and guide the use of antibiotics are critical for the prevention of antibiotic resistance. Efforts to improve personal and domestic hygiene, including educational campaigns to promote appropriate handwashing, should be encouraged.

Identification and antimicrobial resistance patterns of bacterial enteropathogens from children aged 0–59 months at the University Teaching Hospital, Lusaka, Zambia: a prospective cross sectional study

“…Four strains of DEC (ETEC, EIAC, EAEC and EPEC) were the third most common group of enteropathogens, accounting for 18.0% of all isolates. The predominance of ETEC strain, among the DEC, in agreement with previous studies carried out in Bangladesh, Tunisia and Kenya [ 24 – 26 ]. ETEC was associated with one third of diarrhoea cases identified in children in the recent GEMS Study [ 4 ].…”

Household-stored drinking water quality among households of under-five children with and without acute diarrhea in towns of Wegera District, in North Gondar, Northwest Ethiopia

“…Based on a similar study, we assumed that minimal prevalence of the fecal indicator among diarrhetic U5 children would be 71% and among non-diarrheic 90% (Boru et al 2013 ). The alpha error was set at 5% and the power of the study at 80%.…”

Profil et antibiosensibilité des bactéries pathogènes associées aux diarrhées chez les patients consultant à l’Hôpital Régional Annexe de Kousseri, Extrême-Nord Cameroun

“…Cette situation se conforte par le fait que les causes virales qui sont connues dans la littérature comme étant les plus fréquentes n'ont pas été investiguées. Dans certaines études, cette situation a été clarifiée en conduisant une étude cas témoins dans laquelle les mêmes germes étaient recherchés chez les cas constitués de personnes présentant la diarrhée et les témoins constitués des personnes appariés sans diarrhées [ 9 ]. Ce schéma a permis d'estimer et comparer la probabilité de survenues d'un germe suspect pathogène entre les groupes des cas de diarrhée et ceux des témoins.…”