Abstract

Parasites and bacterial infections which cause diarrhoea among children is a significant health problem worldwide. This cross sectional study was undertaken to investigate the variation of intestinal parasitic and bacteria causes of diarrhea in children 0-5 years of age presenting with symptoms of intestinal infections in the Buea Regional Hospital.

The objectives of this study were to determine intestinal parasitic and bacteria causes of diarrhea amongst children, to investigate the risk factors predisposing intestinal parasitic and bacterial infections, during the period extending from May 2022 to June 2022. A total 200 cases were included in the study.

The parasite either highest percentage of parasitic infections had 76% and bacteria 32%. We identified the following major diarrhea determinants were poor sanitation, water source, low socioeconomic status, and low parent education. Entamoeba hystolytica was found to have an infection rate of 76%, followed by Ascaris lumbricoides 37%, Giardia lambia 22%,Entamoeba histolytica 5%.

Amongst the intestinal bacteria,the highest occurring was Shegella 32%, followed by Staph aureus 14%. In conclusion, this study demonstrate that Entamoeba  histolytica, Ascaris lumbrisoides and Giardia lambia,for parasite poor meanwhile Staph aureus and Salmonella for bacteria are the main determining causes for diarrhea in children 0-5 years of age and that poor hand sanitation, poor water supply, and slow socioeconomic status sre the main predisposing factors that expose children to parasites and bacterial infections causing diarrhea. Mass deworming programs are recommended for pre-school and school children, as this population is easily accessible.

CHAPTER ONE

GENERAL INTRODUCTION

1.1 Introduction

Gastrointestinal infections are Viral, bacterial or parasitic infections that cause gastroenteritis, an inflammation of the gastrointestinal tract involving both the stomach and the small intestine. Gastrointestinal infections are the major cause of morbidity and mortality particularly in developing countries where mortality rate due to infections diarrhea is 50% (Henriken et al.,2017). Children and young adults are the most affected, particularly in regions with limited resources and where hygienic measures are not strictly followed (Becker et al, .2015).

In Africa, diarrhea has been estimated to be responsible for 25-75% of all childhood illnesses (Dib et al., 2008), and episodes of diarrhea led by 14% of outpatient visits and 16% hospital admission and accounted for an average of 35 days of illness per year in children aged less than 5 years (Lallo  et al., 2012). Causes of diarrhea in endemic areas include a wide variety of bacteria, viruses, and parasites.

In Buea, there is adequate information on the magnitude of parasitic infection among cases attending hospitals. It has been described that information generated from inpatients department of hospitals may provide the minimal needed for planning meaningful public control programs (Obiamiwe, 2012).

Intestinal parasites are associated with serious clinical diseases and mortality and are known to cause malnutrition and impairment of physical development in children and affect their growth and learning (Valenciano et al., 2013). It is, thus, necessary to have a fairly-accurate picture of the situation to target interventions in affected areas. Occasionally the definition of parasitic disease is restricted to disease due to endo-parasite. Intestinal helminthes and protozoans parasite are the major public health problems in developing countries (Lwambo et al,. 2014). Bacterial organisms, such as Campylobacter spp., Salmonella spp., Shigella spp., and different groups of entero-pathogenic Escherichia coli are well- known as cause of gastrointestinal disease all over the world (Abdel et al., 2016). Infections by most of these organisms can be asymptomatic, or can be treated with rehydration solution, particular in the case of viruses and some bacteria. (Aremu et al., 2011)

1.2 Rationale of the study

Parasitic and bacterial infection is among the most requested routine laboratory test in Cameroon. This can be due to poor personal hygiene and general sanitation which causes reinfection, such as even when individuals are treated, they usually come back to the hospital with the same manifestation.

Also, despite the high frequency of surveillance of these infections, to determine the actual prevalence, coupled with the efforts of World Health Organization (WHO) to eradicate these infections, intestinal parasitic and bacterial infections is still public health problem.

It is therefore highly imperative to investigate the variation and causes of diarrhea in patient’s presenting with diarrhea in the hospital in attempt to provide information that help public health experts to came with regulations to control these infections.

1.3 Hypothesis

The causes of parasitic and bacterial infection in children around the Buea

1.4 Main objective

This study is designed to investigate the causes of intestinal parasitic (helminthes and protozoan) and bacteria causes of Diarrhea amongst children from 0-10years of age presenting with symptoms of intestinal infections around the Buea Health Districts.

1.5 Specific objectives

1. To determine the causes of intestinal helminthes and protozoans. To determine the causes of intestinal bacterial infection.
2. To investigate the risk factors predisposing intestinal helminths, protozoans and bacterial infections.

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