Magnitude and Associated Factors of Enteric Pathogens, and Antimicrobial Susceptibility Pattern of Bacteria among Children with Acute Diarrhea in Government Health Institutions, Arba Minch, southern Ethiopia

Abstract

Introduction: Infectious diarrheal illness continues to be the predominant cause of morbidity and mortality among children in developing countries, including Ethiopia. Moreover, the emergence of multiple drug-resistant entero-bacteria worsens the condition. There is a gap regarding the magnitude, etiology, and associated factors of enteric pathogens among diarrheal children in the study area. Objective: This study aimed to determine the magnitude and associated factors of enteric pathogens and the antimicrobial susceptibility pattern of bacteria among children with acute diarrhea attending four Government Health Institutions, in Arba Minch, Southern Ethiopia, from October 21st to December 30th, 2022. Methods: A health institution-based cross-sectional study design was employed in four health facilities at Arba Minch. Three hundred sixty-seven diarrheal children aged 1–14 years were enrolled using systematic random sampling. The data were collected using a semi-structured questionnaire. The fecal sample was inoculated into a series of culture media, and standard bacteriological techniques isolated enteric bacteria. Wet mount and formol-ether concentration techniques were used for the identification of enteroparasites. Antimicrobial susceptibility tests were done using the Kirby Bauer disk diffusion technique. Descriptive and inferential statistical analyses were conducted using SPSS version 26 software; a P-value ≤0.05 was considered statistically significant. Results: From a total of 367 participants, 146 (39.77%) were positive for any of the enteropathogens, which comprise 138(37.6%) enteroparasites and 8(2.17%) entero-bacteria. Giardia lamblia 66 (17.98%) and Entameoba histolytica 42(14.44%) were predominant enteroparasites. Shigella dysentery 4(1.08%) and Campylobacter jejunum/coli 2(0.54%) were dominant bacteria. All bacterial isolates were 100% susceptible to ciprofloxacin. However, Salmonella Typhimurium, S. dysentery, and C. jejunum/coli showed 100% resistance to ampicillin. Bloody diarrhea [(AOR=3.018, 95% CI (1.659-5.488)] and parental/guardians education (no formal education) [(AOR=5.466, 95% CI (1.793- 16.661)] were factors associated with enteric pathogens infection. Conclusion and recommendations: This study found that magnitude of enteropathogens was high among diarrheic children with G. lamblia predominant followed by E. histolytica/dispar, and a few of the entero-bacteria species. Ciprofloxacin was an effective antibacterial drug. Having bloody diarrhea and parental education were factors associated with entero-pathogens infection. Providing information regarding transmission of enteropathogens would be the most important intervention to be emphasized to control diarrheal diseases in the children population.