Magnitude, risk factors and antimicrobial susceptibility pattern ofShigellaandSalmonella, among children with diarrhea in Southern Ethiopia: A Cross-sectional Study

Abstract

Objective: This study was aimed at identifying Shigella and Salmonella infection, their antibiotic susceptibility pattern and associated risk factors among children with diarrhea who attended Alamura Health Center. Method: A facility-based cross-sectional study was conducted on 263 children aged below 14 years with diarrhea. A structured questionnaire was used to collect socio-demographic and clinical data after obtaining the necessary consent from their parents or caretakers. The culture and sensitivity tests were performed using the standard operating procedure of the microbiology laboratory. Results: Accordingly, 20/263 (7.6%), 95% confidence interval: 4.4%–11.4% Shigella and 1/263 (0.38%), 95% confidence interval: 0.0%–1.1% Salmonella were isolated. Shigella dysenteriae was dominant 11 (4.2%), followed by Shigella spp. 9 (3.42%) and Salmonella typ 1 (0.38%). The isolates showed 71.4% overall resistance to ampicillin and 61.9% for augmentin and tetracycline, whereas 95.2% of the isolates were sensitive to ciprofloxacin, 85.9% to ceftriaxone and ceftazidime, 81% to gentamycin, 76.2% to chloramphenicol, 66.7% to cefuroxime and 52.4% to cotrimoxazole. The habit of washing hands after toilet use for a while (adjusted odds ratio: 235.1, 95% confidence interval: 20.9–2643.3, p < 0.000) and storing cooked food in an open container for later use (adjusted odds ratio: 36.44, 95% confidence interval: 5.82–228.06, p < 0.000) showed a statistically significant association. Conclusion: High level of Shigella and single Salmonella was isolated. Ampicillin, augmentin and tetracycline were resistant and ciprofloxacin, ceftriaxone, ceftazidime, gentamycin, chloramphenicol, cefuroxime and cotrimoxazole were relatively sensitive. Hand-washing after defecation for some time and storing of foods for later use in an open container were statistically associated. Therefore, to alleviate this infection, the concerned body should focus on imparting health education for hand-wash after defecation and storing food in a closed container for later use is mandatory.

Prevalence, antimicrobial resistance pattern, and associated factors of Salmonella and Shigella among under five diarrheic children attending public health facilities in Debre Markos town, Northwest Ethiopia

“…This is in line with a study conducted in Addis Ababa 91.4% (11). In contrast, it is higher than reports from Gondar 10.3% (28), Alamura 55.6% (20), and French Guiana 12% (52). In our study, the resistance rate of Shigella species for ampicillin was 73.7% (14/19; 95% CI: 53.9-93.5).…”

“…In our study, the resistance rate of Shigella species for ampicillin was 73.7% (14/19; 95% CI: 53.9-93.5). This finding is comparable with reports from Ethiopia; Gondar 76% (28), Hawassa 63.6% (12), Alamura 81.8% (20), Hosanna 82.4% (17), Ambo 88.9% (16), Dire Dawa 90.9% (13), and also different countries such as French Guiana 58% (52), Iran 67.8% (44), and another study in Iran 61.5% (53). Moreover, it is also in line with the result of pooled Ethiopian studies 83.1% (54).…”

“…Different factors may contribute to the transmission and spread of bacterial etiologies of diarrhea in under-five children. These factors could be personal and/or environmental factors, behavioral and hygiene-related factors, socio-demographic factors, or clinical factors (12)(13)(14)(15)(16)(17)(18)(19)(20).…”

“…These countries are victims of antimicrobial resistance because of unnecessary consumption, compromised drug quality, lack of continuous surveillance, poverty, and antimicrobial misuse in cattle and poultry feed ( 27 ). In developing countries, the increasing emergence of antimicrobial-resistant Salmonella serovars and Shigella species to commonly prescribed antimicrobials such as chloramphenicol, ampicillin, tetracycline, and co-trimoxazole has been documented in recent years ( 18 , 20 , 28 ). Therefore, continuous study is important to help solve the problem.…”

“…In Ethiopia, the high prevalence of salmonellosis and shigellosis in under-five children is associated with different factors including the lower level of maternal education status, low family economic status, improper disposal of waste, poor handwashing practice, improper disposal of child's feces, low access to clean potable water, and the absence/irregular use of toilet ( 19 , 20 ). According to data from the central statistics agency, the accessibility of improved drinking water sources and toilet facilities in rural households of Ethiopia was only 57 and 4%, respectively ( 29 ).…”