Epidemiological and antibiotic susceptibility profiles of infectious bacterial diarrhoea in Juba, South Sudan

Abstract

Background: Diarrhoeal diseases have remained a major health problem in South Sudan where they accounted 45% prevalence in under five-year olds. Between 2006 and 2007, the country reported a morbidity of 8,337 cases and 176 deaths due to diarrhoeal outbreaks.

Methodology: We investigated causative agents of diarrhoeal diseases and their antibiogram in persons presenting with diarrhoea to selected health facilities in Juba.

Results: Bacterial agents were prevalent in 20 (6.9%) of the 286 patients with 5.7% (4/70) in under five-year olds alone. S. dysenteriae 50% (10/20) accounted for the majority of the identified pathogens followed S. flexneri 25% (5/20) and S. typh 25% (5/20). Antibiotic testing showed that S. flexneri (5/5) and S. typhi (5/5) were all 100% sensitive to ceftriaxone, and gentamicin while S. dysenteriae had varying sensitivity to ciprofloxacin (70%), nalidixic acid (90%), and ceftriaxone(100%). These pathogens had 100% resistance to amoxicillin, ampicillin, tetracycline and cotrimoxazole. No difference existed in isolation rates among different age groups, educational status, gender, water drank, use of chlorine, toilet use, exposure at home to diarrhoea patient, hand washing with soap and location of residence. However, diarrhoeagenic bacteria isolation was higher for participants with no source of income (OR=6.08, p<0.05).

Conclusion: With emerging menace of resistance to commonly used antibiotics in South Sudan we recommend antibiotic resistance monitoring and regulation of antibiotic use.