Epidemiology of Shigella, Salmonella, and Campylobacter among diarrheic under-five-year-old children in central Ethiopia

Abstract

INTRODUCTION: Diarrheagenic bacteria are among the major contributors to the global diarrheal burden. The absence of up-to-date data on the etiologies of diarrhea due to limited active surveillance and clinical laboratory capacity makes the burden more severe. Shigella, Salmonella, and Campylobacter are among the most common bacterial etiologies of childhood diarrhea. The present study aimed to provide epidemiological data on these bacterial etiologies in under-five-year-old children in Ethiopia. METHODOLOGY: A cross-sectional health facility-based study was conducted from December 2020 to August 2021 in Addis Ababa and Debre Berhan, Ethiopia. Standard microbiological techniques including culture, antimicrobial susceptibility, and polymerase chain reaction (PCR) were used to characterize bacterial isolates. RESULTS: A total of 391 under-five-year-old children were tested. Shigella was the most common isolate in 10% (39/391), followed by Campylobacter in 7.2% (28/391). Age range of 0-12 months, poor childcare practice, and taking supplements early were associated with acquisition of the pathogens. The highest antibacterial resistance was observed for ampicillin among Salmonella and Shigella (100% and 87%, respectively). Extended spectrum ß-lactamase (ESBL) and carbapenemases production was observed in 8% and 3% of Shigella strains respectively. The majority of the bacterial isolates were susceptible to carbapenems. CONCLUSIONS: The burden of bacterial pathogens continues to be a serious problem in Ethiopia. Detection of ESBL-and carbapenemase-producing Shigella strains could reveal the presence of resistant pathogenic strains in the area. Strengthening diagnostic laboratory capacity in healthcare facilities could reduce the burden.