Abstract:
Over a period of 2 years (From January 2006 to January 2008), 710 faecal
samples were collected from residents of two internally displaced persons
camps, Khartoum State, with acute or chronic diarrhea, and investigated
for bacterial, viral, and parasitic enteropathogens.
Specimens were collected from patients who were attending clinics (all
age groups were included) using standard method, microbiological
investigations were performed using conventional and molecular
methods.
The results revealed that 77.5% of patients with diarrhea were infected
with enteropathogens, among them 35.2% had a parasitic, 26.8% a
bacterial, 13.9% a viral, and 1.5% had mixed infections.
Shigella spp. was the pathogen most frequently detected, accounting for
15.5% of all positive findings in the patients, followed by Rotavirus
(14.8%), Hymenolepsis nana (13.4%), however, Schistosoma mansoni
and Cryptosporidium spp. were the least detected pathogens (1.1% each).
Most of patients affected with diarrhea were children under five years
(46.5%), and Rotavirus was the most prevalent enteropathogen in this
age group with 29.6% frequency rate, however it was Shigella spp.
among adults, and children over 5years (18.3% both), and most of
Shigella spp. were S. dysenteriae (42.5%).
Further characterization of identified Rotavirus isolates was done using
real time polymerase chain reaction (RT-PCR), revealed that, they were
type A (95.2% ), and type C (4.8%).
Out of the total bacterial pathogens, high resistance was observed against
amoxicillin (70.9%) then erythromycin (48.7%), and co-trimoxazole
(45.2%). And the lowest resistance to cefuroxime (26.6%).
Most of the Shigella spp. isolates were sensitive to cefuroxime (65.5%),
but high degree of resistance was observed against amoxicillin (73.6%).
Most of the patients consumed untreated drinking water, depend on
donkey carts as water source, live in very poor condition, they suffering
from crowdness, and had no disposal latrines; all of them were risk
factors for acquiring diarrhea.
In conclusion, these results revealed that most of diarrhea cases in
displaced camps were of parasitic etiology. The most affected group was
children under five years. The most frequently identified pathogen was
Shigella spp., and most of it were multidrug resistant. Rotavirus had big
role in diarrhea, mainly type A especially among children under five
years. Further research is needed to adapt and simplify interventions, and
to explore novel diagnostics, vaccines, and therapies.
