Abstract

Diarrhea disease is among the leading causes of mortality and morbidity worldwide. Diarrhea disease had remained a significant public health challenge in the developing countries including Cameroon. The aim of this study was to determine the prevalence of different bacteria that cause diarrhea among children age 0-5 years attending Buea Regional Hospital.

A total of 30 diarrhea stool samples were obtained from both male and female children using wide mouthed screw cap containers. The stool samples were cultured on three different culture media ( SSA, MacConkey agar, and Mannitol salt agar) to isolate the bacteria.

From the stool culture, 5 bacteria spp were isolated from the stool samples with some having more than one bacteria spp. Some children had one bacteria spp (7%), some had two bacteria spp (27%), others had three bacteria spp (63%), while one child had four bacteria spp (3%). From the bacteria isolated, E. coli had the highest prevalence of 90.0%, Salmonella (76.7%), Staphylococcus aureus (53.3%), Shigella spp (33.3%) and Klebsiella spp (16.7%). The gender distribution showed that the prevalence was higher in females patients (56.7%) and (43.3%) male.

The study had high bacteria spp   from participants of age group 0-2 with prevalence of (56.7%) while the lowest was observed in the age group 3-5 years with prevalence (43.3%). Use of flushing toilets (53.3%) or use of tap water (36.7%), contact with pets (36.7%) and those who eat outside (66.7%) were risk factors of bacteria diarrhea infection.

These findings highlight the need of reinforcement of hygiene promotion especially among those who prepare food and municipal water supply and intensification of environmental interventions.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

World Health Organization defines diarrhea as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual (WHO, 2007). Worldwide, diarrhea diseases are reported as the leading cause of mortality among children aged five years and below (UNICEF, 2018). In some parts of the world, they account for higher mortality rates than all other causes combined (UNICEF, 2018).

Diarrhea affecting children five years old and below accounts for approximately 63% of the global diarrhea burden (Zhang et al., 2016), and is the second significant cause of infant mortality in developing nations (Kotloff, 2017) where poor sanitation and insufficient potable water supply are key factors (Chakravarty et al., 2017; Squire and Ryan, 2017). In Africa, Asia, and South America, diarrhoea accounts for one in eight deaths among children younger than 5 years per annum (Kotloff, 2017) and an estimated 16% of child deaths.

Bacterial diarrhoeal cases are the most prevalent of all diarrhoeal cases around the globe (Zhang et al., 2018). Commonly reported enteric bacterial diarrhoeal diseases and the causative agents are botulism (Clostridium botulinum), Campylobacter gastroenteritis (Campylobacter jejuni), cholera (Vibriocholerae), Escherichia coli gastroenteritis, Salmonellosis (various Salmonella serovars), Shigellosis (Shigella spp.), and Staphylococcal food poisoning (Staphylococcus aureus enterotoxins) (Tarr et al., 2018).

Children below five years of age have the most at risk from foodborne pathogens, including Shiga toxin-producing Escherichia coli O157, Campylobacter, Shigella, Yersinia, Salmonella, and Cryptosporidium (Kotloff, 2017). In the past few decades, the awareness in handwashing has tremendously reduced the burden of diarrhoea caused by enteric bacteria (Tagbo et al., 2019).

1.2 Statement of the problem

The mouth is the typical portal of entry for gastrointestinal pathogens, which are ingested alongside contaminated food and water. Also, diarrhea is acquired via contact with diarrhoeic animals and their contaminated environments or with the faecal matter of a diarrhoeic person (Squire and Ryan, 2017).

Children with poor nutritional status and overall health, as well as those exposed to unsafe drinking water are more susceptible to severe diarrhoea and dehydration than healthy children. Children are at greater risk than adults of life-threatening dehydration since water constitutes a greater proportion of children’s bodyweight.

Young children use more water over the course of a day given their higher metabolic rates, and their kidneys are less able to conserve water as adults. Without quality control measures, it may lead to high mortality rate of children less than ten years.

1.3 Research Questions

1. What is the prevalence of different bacteria causing diarrhea in children?
2. What is the most prevalent bacteria associated with diarrhea in children?
3. What are the risk factors for diarrhea among guardians taking care of children?

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