dc.description.abstract |
Diarrheal diseases are among the leading causes of under-five mortality in low and
middle-income countries. Having many reservoirs, factors, transmission routes, and
antimicrobial resistance by the causative agents, threaten the effective prevention of
diarrheal disease. This study aimed to determine the prevalence of enteric bacterial
pathogens and their antibiotic susceptibility in diarrheic under-five children, the
association of bacterial pathogen prevalence with the nutritional status of the children, the
role of cattle as a possible source of bacterial pathogens, and the spatial distribution of
diarrheal diseases in Bahir Dar Zuria Districts, Ethiopia. A cross-sectional study was
carried out from February 2021 to March 2022 at seven Health Centers. A total of 196
diarrheic under-five children visiting the Health Centers and 317 cattle from the
households of the children were included in the study. Stool samples from diarrheic
under-five children and fecal samples from cattle were collected for the isolation of
enteric bacterial pathogens. SPSS version 26, WHO Anthro version 3.2.2, and ArcGIS
version 10.4 software were used for data analysis. All analyses were conducted at a 95%
confidence interval and significant association was determined using P-value <0.05. The
overall isolation rates of Salmonella, Shigella, and E. coli O157:H7 in under-five children
and cattle were 13.27% and 9.2%, respectively. For most isolates, a high level of
antibiotic resistance was observed to cotrimoxazole, ampicillin, norfloxacin, and
tetracycline. From the isolates of Salmonella, Shigella, and E. coli O157:H7 in under-five
children, 83.3%, 37.5%, and 83.3% were multidrug resistant respectively. Among
Salmonella, Shigella, and E. coli O157:H7 isolated from cattle, 46.1%, 33.3%, and 57.1%
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were multidrug resistant respectively. Watery diarrhea and fever were the most common
clinical characteristics observed in children who were positive for enteric bacteria. The
prevalence of stunting, underweight, and wasting were 56.6%, 24.4%, and 13.2%,
respectively. Stunting and underweight were not associated with the prevalence of
Salmonella, Shigella, and E. coli O157:H7 (P > 0.05). Wasting was significantly
associated with the isolation of Salmonella spp. (P=0.02). The distribution of diarrheal
disease in the study area was not random. A high prevalence of diarrhea cases was
observed in the dry season, and at the beginning of the rainy seasons. Overall, the
prevalence and antimicrobial resistance level of bacterial pathogens in diarrheic under
five children and cattle in the study area were high. Stunting, wasting, and being
underweight are important nutritional deficits of diarrheic under-five children in Bahir
Dar Zuria District. Further studies targeting possible sources, transmission routes of
bacterial pathogens, and determinants of the low nutritional status of children are
suggested. Enhance good nutritional practices by creating awareness on child feeding,
and treatment of extremely malnourished children by the provision of micronutrients is
essential. Emphasis and intervention are required for the reduction of diarrheal diseases
in the identified diarrhea hotspots and risky areas.
Keywords: Antibiotic resistance, Bahir Dar Zuria District, Cattle, Diarrhea, Enteric
bacteria, Children, Undernutrition, Diarrhea distribution |
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