Community-acquired infectious diarrhoea in children under 5 years of age in Dakar, Senegal

Jean-Marie Sire (1, 2) , Benoit Garin (3, 1) , Loïc Chartier (4) , Ndeye Khota Fall (1) , Adama Tall (1) , Abdoulaye Seck (1) , François-Xavier Weill (5) , Sébastien Breurec (1) , Muriel Vray (4)

1 Institut Pasteur de Dakar
2 CHI Poissy-Saint-Germain
3 Institut Pasteur de Madagascar
4 Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology
5 BPE - Bactéries pathogènes entériques

BACKGROUND: In sub-Saharan Africa, infectious diarrhoea is a major cause of childhood morbidity and mortality. A cross-sectional study was undertaken to document the pathogens potentially involved in community-acquired childhood diarrhoea in Dakar, the capital of Senegal. METHODS: Between September 2007 and March 2008, 176 children aged 1 month to 5 years were recruited consecutively from a primary health care institution in an urban area. Clinical data were recorded and stool samples were collected. Bacterial pathogens were identified using conventional methods and/or PCR assays. Rotaviruses and adenoviruses were detected by a rapid immunochromatographic test. Intestinal parasites were diagnosed by microscopy. RESULTS: Rotavirus was the most common enteric pathogen, detected in 27% of patients, followed by Shigella (12%), diarrhoeagenic Escherichia coli (8%), enteric adenovirus (8%), Salmonella (4%), Campylobacter jejuni (3%) and Plesiomonas shigelloides (2%). Mixed bacterial/viral infections were detected in 6% of cases. Parasites, mostly protozoa, were detected in 14% of children. Using ipaH PCR, 30% of samples were positive for Shigella/entero-invasive E. coli. Detection of rotavirus was more frequently associated with younger age groups (<24 months), whereas bacterial diarrhoea was isolated more often in children over 1 year of age. Detection of bacterial pathogens was significantly associated with malnutrition. Antibiotics were prescribed for 77% of children who attended for consultation. No pathogen was found in 36% of them, whereas a virus was detected without any other associated bacterial or parasitic pathogen in 23% of patients. CONCLUSION: In developing countries, there is a need to develop reliable, easy-to-use, inexpensive rapid diagnostic tests to guide the management of diarrhoea in infants and children and thereby prevent over-use of antimicrobial agents.

Domains: Life Sciences [q-bio]; Santé publique et épidémiologie

Jean-Marie Sire, Benoit Garin, Loïc Chartier, Ndeye Khota Fall, Adama Tall, et al.. Community-acquired infectious diarrhoea in children under 5 years of age in Dakar, Senegal. Paediatrics and International Child Health, 2013, 33 (3), pp.139-144. ⟨10.1179/2046905512Y.0000000046⟩. ⟨pasteur-02025043⟩