Acute Diarrhea in Children Less than Five Years of Age: Epidemiology of Bacterial Pathogens

Objectives: Acute diarrhea is among the leading causes of mortality and morbidity worldwide. Bacteria tend to cause more fatal illnesses and complications such as septicemia and persistent diarrhea. This study aimed to determine the causes of acute diarrhea, laboratory and clinical predictors of bacterial causes, and antimicrobial resistance pattern among the isolates among children in Dar es salaam, Tanzania. Methods: A cross-sectional hospital-based study was conducted in Dar es salaam Hospitals from April 2015 to March 2016 among children below five years of age who presented with acute diarrhea. Demographic characteristics and results from stool specimen analysis, complete blood count, C- reactive protein and antimicrobial resistance results were recorded using a pre-structured clinical research form. Results: Among 200 children enrolled, viruses were identified in 149 (74.5%) of the cases. Bacterial pathogens were found in 15 (7.5%) cases only. Elevated stool red blood cell count, stool white blood cell count, and fever were highly associated with enteric bacterial pathogens (p<0.001, p=0.002 and p=0.04 respectively). Most of the bacterial isolates were resistant to Cotrimoxazole and erythromycin but highly sensitive to ciprofloxacin and Ceftriaxone. Conclusion: Fever, elevated stool leukocyte and elevated stool red blood cells are significant predictors of bacterial enteric pathogens in children with acute diarrhea. These parameters may guide clinicians in resource-limited settings in the diagnosis and management of acute diarrhea. Further studies should be conducted to determine local antimicrobial resistance patterns. J Microbiol Infect Dis 2020; 10(3): 208-214.