Faecal Leucocyte Count and its Relationship with Bacterial Diarrhoeas in South East Nigeria.

Abstract

Aim: To determine the usefulness of fecal leucocyte count in predicting the need for antibacterial agents in the management of childhood diarrhea in southeast Nigeria.
Methods: A two-year prospective study (Jan 1998-Dec1999 inclusive) of 211 patients with non-bloody diarrhea was done in a private children specialist hospital in southeast of Nigeria. The stool of each of these patients was subjected to macroscopic and microscopic analysis and the findings documented. The patients were put on oral rehydration solution (ORS) and seen subsequently every two days. During the visits, the progression or otherwise of their diarrhea determined further intervention with antibacterial agents. At resolution, the result of the stool macroscopy and microscopy of each patient taken at the visit when the decision to either give antibacterial agents (worsening) or not (improving) was taken and subsequently patient improved, was correlated with the decision taken on such a patient. The results were subjected to X2 analysis and the critical values determined. Also the means and standard deviations where relevant were calculated.
Results: The results showed that a total of 86 out of 211 of the cases needed antibacterial agents; 67 as single therapy and the rest as combination therapy with other drugs for other conditions diagnosed. Additionally, for the samples that had >8wbc/hpf, 31 out of 36 of them required antibacterial agents, while for those that had<2wbc/hpf, 70 out of 75 did not. [X2 = 81.02 X2 3,0.05 = 7.815 (P<0.05)]. Conclusion: These results show that in non-bloody diarrhoeas in children in this environment, the fecal leucocyte count could be used to determine those that will need antibacterial agents.

Keywords: Diarrhoea, Leucocyte, Children.

Journal of College of Medicine Vol. 13 (1) 2008: pp. 23-28