Acute diarrhoea in hospitalized under-five children in Ilorin, Nigeria: Relationship between isolated enteropathogens and clinical outcome

Abstract

Background: Acute diarrhoea due to different enteropathogens contributes significantly to childhood morbidity and mortality globally, despite the advances made in diarrhoea management via use of fluid therapy and zinc supplementation.

Aim: To determine the prevalence of bacterial and viral etiology among children hospitalized with acute diarrhoea and the relationship with clinical outcome.

Methods: A total of 135 children aged one to 59 months with acute diarrhoea were recruited in Ilorin, Nigeria. Stool specimens were investigated for three viruses (rotavirus, adenovirus and norovirus) and bacterial pathogens using immunochromatographic and conventional culture techniques respectively.

Results: One hundred and twenty-two (90.4%) study participants had stools that yielded enteropathogens, while 13 (9.6%) had no isolates. Sixty-one (45.2%) children had a single pathogen isolated, while 61 (45.2%) had co-infections. The prevalence of viruses was 17.0% with rotavirus, adenovirus and norovirus detected in 10.3%, 3.7% and 3.0% respectively. Bacterial pathogens were isolated in 28.2% with Escherichia coli (14.1%), Klebsiella spp. (8.2%), Proteus spp. (3.7%) and Pseudomonas aeruginosa (2.2%) detected as isolates. The duration of hospital stay, likewise the duration of diarrhoea were prolonged by the presence of an infectious aetiology and co-infections (p <0.001 and p =0.04 respectively). However, these clinical outcomes were not influenced by the type of bacteria/virus isolated nor the enteropathogens constituting co-infection (p >0.05).

Conclusions: There was a high burden of infectious aetiology of childhood diarrhoea, with bacteria being the predominant enteropathogens isolated. The clinical outcomes of the children studied were influenced by the isolation of enteropathogens and the presence of multiple infections.