Salmonella spp, Shigella spp, Escherichia coli, Diarrhea, prevalence, antimicrobial susceptibility, children under five yearsBackground: Diarrhoea is one of the leading causes of death, poor health and disability among children aged under five years in developing countries.
Aims: This study aimed at providing evidence of the prevalence and
antimicrobial resistance patterns towards Salmonella
spp., Shigella spp. and Escherichia coli among under-five
children in Unguja – Zanzibar, Tanzania.
Study Design: This cross-sectional design was used to collect
samples from stools of children suffering from diarrhoea.
Place and Duration of Study: The study was carried out in
Zanzibar's western urban region between October 2019 to February 2020.
Methodology: A cross-sectional study was conducted from October
2019 to February 2020. Random samples were collected to investigate the
prevalence of Salmonella spp., Shigella spp. and Escherichia coli. The
samples were cultured using Hektoen Enteric (HE) and Salmonella-Shigella agar.
Antibiotic susceptibility testing was done by the Kirby–Bauer disc diffusion
method.
Results: A total of 159 stool samples were collected in the study;
Salmonella spp. was identified 12/159
times (7.5%) of the total samples. Shigella
spp. and E. coli were identified in 7/159 samples (4.4%) and 6/159 (3.7%),
respectively. The age range of 1- 3 years were more susceptible to diarrhoea
caused by Salmonella spp. 12 (7.5%)
than Shigella spp. 7 (4.4%) and Escherichia coli 6(3.7%) These results
indicated that there is no statistically significant relationship between the
age of patients and identification of Salmonella
spp., Shigella spp. and Escherichia coli (chi-square with four
degrees of freedom = 2, p = 0.064). Children between 49 and 60 months showed
low prevalence, while a high peak prevalence was reported for children between
7–12 months. All Salmonella spp., Shigella spp. and Escherichia coli species identified were sufficiently susceptible
to chloramphenicol and ceftriaxone, with a varying pattern to azithromycin,
ciprofloxacin, ampicillin, nalidixic acid and trimethoprim-sulfamethoxazole.
The multiple drug resistant (MDR) patterns of Shigella and E. coli exhibited to
four antibiotics trimethoprim-sulfamethoxazole, azithromycin, ceftriaxone and
nalidixic acid while Salmonella isolates showed low resistance pattern to three
antibiotics nalidixic acid, azithromycin and ampicillin. The correlation
between the total identification of microbes and the date collected stools is
significant at p = 0.020. ANOVA test used a linear relationship. The
relationship between isolated pathogenic bacteria and the date of collected
diarrheagenic stools was positive (3.515), based on the t-value (2.506) and
p-value (0.02). The study benefit to guide the first-line and second-line drug
choice in the treatment of diarrhoea in the subsequent reviews of the Zanzibar
Standard Treatment Guideline (ZSTG) for Diarrhoeal diseases, as needed by
Ministry of Health, 2016 and to initiate a long-term surveillance program to
monitor and identify the changes in the rate of antimicrobial patterns of these
bacteria of public health concern. Future research should extend the study to include
other regions of Zanzibar and conduct molecular data, this will provide a more
comprehensive understanding prevalence and antimicrobial resistance of
diarrhoeagenic pathogens.
Conclusion: We found Salmonella
spp., Shigella spp. and Escherichia coli isolates in the stools
of children ≤ 5 years from Unguja, Zanzibar, but all the isolates were
susceptible to chloramphenicol and ceftriaxone but partially resistant to other
tested antibiotics. Identifying resistant bacteria in this age group should be
a concern for the public health authorities and trigger research into finding
the cause.
Author
(s) Details
Kheir M. Kheir
Department of Molecular Biology and Biotechnology, University of Dar es
Salaam, PO Box 35179, Dar es Salaam, Tanzania.
Bernard Mbwele
Department of Epidemiology and Biostatistics, University of Dar es Salaam
–Mbeya College of Health and Allied Sciences, PO Box-608, Mbeya, Tanzania.
Khadija N. Omar
Zanzibar Livestock Research Institute (ZALIR), Ministry of Agriculture,
Irrigation, Natural Resources and
Livestock, PO BOX 104, Kizimbani Zanzibar, Tanzania.
Modester D. Nkungu
Department of Molecular Biology and Biotechnology, University of Dar es
Salaam, PO Box 35179, Dar es Salaam,
Tanzania.
Lucy A. Namkinga
Department of Pharmacology and Biochemistry, University of Dar es Salaam –
Mbeya College of Health and Allied Sciences, Mbeya, Tanzania.
Please see the book here:- https://doi.org/10.9734/bpi/rpmab/v9/3726
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