Evaluation of detection methods for Campylobacter infections among under-fives in Mwanza City, Tanzania

Abstract

IntroductionCampylobacter species are recognized as a major cause of acute gastroenteritis in humans throughout the world. The diagnosis is mainly based on stool culture. This study was done to evaluate the effectiveness of staining methods (Gram stain using 0.3% carbol fuchsin as counter stain and 1% carbol fuchsin direct stain) versus culture as the gold standard.MethodsA total of 300 children attending Bugando Medical Centre (BMC) and the Sekou Toure regional hospital with acute watery diarrhea were enrolled. Two sets of slides were prepared stained with 1% carbol fuchsin for 30 seconds first set, and the second set stained with Gram's stain using 0.3% carbol fuchsin as counter stain for five minutes. Concurrently, stool samples were inoculated on Preston Agar selective.ResultsOf 300 stool specimens, 14(4.7%) showed positive culture after 48 hours of incubation and 28 (9.3%) shows typical morphology of Campylobacter species by both Gram stain and direct stain. The sensitivity of the Gram stain using 0.3% carbol fuchsin as counter stain and 1% carbol fuchsin simple stain versus culture as gold standard was 64.3%, with a specificity of 93.4%. The positive predictive value and negative predictive value were 32.1% and 98.2% respectively.ConclusionThe detection of Campylobacter by 1% carbol fuchsin is simple, inexpensive, and fast, with both a high sensitivity and specificity. Laboratories in settings with high prevalence of campylobacteriosis and/or limited resources can employ 1% carbol fuchsin direct stain in detecting campylobacter infections.

Impact of changing from staining to culture techniques on detection rates of Campylobacter spp. in routine stool samples in Chile

“…To overcome this limitation, microscopists should regularly be re-trained and tested. In accordance with other reports, the specificity of Campylobacter staining in our study was high [14, 20–24]. Positive results therefore, provide rapid and clinically relevant information.…”

“…In a previous study using the same technique in Chile, the sensitivity was higher, but the difference was not statistically significant (37.5 %, CI95 % 16.3–64.1) [14]. Other studies using different stains such as Gram, reported much higher sensitivity values from 44 to 94 % [20–24]. Reasons for the lower sensitivity in our study might be the use of a different staining technique, diagnostic settings (study versus routine conditions), study populations (children versus adults), and technical problems with Campylobacter culture, especially in older reports or in studies from developing countries.…”

Isolation of Campylobacter Species in the Stool of Under Five Children With Acute Diarrhea in a Tertiary Care Hospital of Bangladesh

“…But higher prevalence of Campylobacter species were detected in diarrhoeic children 21%. 21 and 47.4%, 23 in Malawi and South Africa respectively; whereas lower prevalence of 2% in Sudan, 24 4.7% in Tanzania, 25 and 7.0% in Kolkata, India. 26…”