Aetiology of acute diarrhoea in hospitalized children, Tripoli, Libya

Gusbi, MM

Abstract

Two studies were performed to detect aetiology of acute diarrhoea in hospitalized children aged under five years in Tripoli, Libya. In the first study, two hundred and thirty-six stool samples were obtained. Of these, 118 were from patients admitted for acute diarrhoeal disease, and 118 age and sex-matched concurrent controls were admitted for other reasons. In the second study, eight hundred and ten stool specimens were collected 405 from patients and the same number from controls. All were admitted to the AIjala Children’s Hospital, Tripoli, Libya. The first study was conducted between August 1st 1997 and 31st October 1997 and the second study was conducted between January 1st 2003 and 31st December 2003. One or more enteric pathogens were isolated from 55.9% of patients and 13.6% of controls in the first study and 68.1 % of patients and 12.6% of controls in the second study.

In the first study, the organisms were identified from stool of patients; Escherichia coli 22.9%, rotavirus 15.3%, Campylobacter 7.6%, Proteus 7.6%, Klebsiella 4.2%, Entamoeba histolytica 4.2%, Cryptosporidium 2.5% and Giardia lamblia 1.7%, Salmonella was not isolated in both studies, because not growth on ordinary media were used (MacConkey agar and Blood agar) but usually growth on Salmonella-Shigella medium where not used.

In the second study, enteropathogens identified were: rotavirus 30.4%, Escherichia coli 16.5%, Entamoeba histolytica 12.5%, Campylobacter 6.7%, Giardia lamblia 3.7%, Cryptosporidium 3.2%, Klebsiella 2.9%, Proteus 2.2%.

Libyan children under six months of age were the most susceptible to acute diarrhoea requiring admission to the hospital. This was remarked in 46.6% of patients in the first study and 43.2% in the second. Exclusive breast feeding in Libyan children was of a very low percentage. In the first study it was 19.5% and in the second 29.1%.

Children use dummies were about 3 times more at risk of diarrhoea than the non users in the first study (OD: 5.95,95%, CI: 1.120-2.37, p<0.001) and RR: 3.1 and (0: : 2.986ý 95%. Cl: 2.13-4.16, P<0.001) and RR: 23 in the second, this fell to children being twice as much at risk of contracting diarrhoea.

Watery stool was the most common stool consistency of patients in both studies. Fever was the most common clinical feature associated with acute diarrhoea in the two studies (72.9% and 71.6% respectively). Vomiting was present in 51.7% of patients among the first study and 58.3% among the second. Moderate and isotonic dehydration were the most common degree and type of dehydration across both studies. In the second study, Rotavirus peaked during the winter (cold season) while bacteria and parasites peaked during the summer and autumn seasons.

API 20E and API Campy were used to identify bacterial isolated by cultures and the number of confirmed cases decreased from 142 to 112 samples.

Polymerase Chain Reaction was adopted in the second study to confirm detection of Campylobacter spp. these were identified by API Campy technique, where all Campylobacter spp. were identified as the same as detected by API Campy and for 24 samples.

Citation

Gusbi, M. Aetiology of acute diarrhoea in hospitalized children, Tripoli, Libya. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Sep 8, 2009
• Publicly Available Date: Sep 8, 2009
• Keywords: Medicine, diarrhoea, children, paediatrics, Libya, Africa, Nutrition, vomiting, aetiology
• Award Date: Oct 1, 2007