Abstract
BackgroundDiarrhoea, although easily curable, is a global cause of death for a half million children every year. Rotavirus and Campylobacter are the most common etiological agents of diarrhoea in children less than 5 years of age. However, in Nepal, these causative agents are not routinely examined for the diagnosis and treatment. The main objective of this study was to determine Campylobacter co-infection associated with rotavirus diarrhoea in children less than 5 years of age.MethodsA cross-sectional study was conducted at Kanti Children’s Hospital (KCH), Kathmandu, Nepal from November 2017 to April 2018. A total of 303 stool specimens from children affected with diarrhoea were processed to detect rotavirus using a rapid rotavirus antigen detection test kit, and Campylobacter by microscopy, culture and biochemical tests. Antibiotic susceptibility tests of Campylobacter isolates were performed according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines 2015.ResultsOf 303 samples, 91 (30.0%) were positive for co-infection with rotavirus and Campylobacter. Rotavirus mono-infection was detected in 61 (20.1%), and Campylobacter mono-infection was detected in 81 (26.7%) samples. Patient’s age, month of infection, untreated water and frequent soil contact were the major risk factors for infections. Clinical features such as > 9 loose motions per day, fever, vomiting, mild to moderate dehydration, diarrhea persisting 6–9 days and presence of mucus in stool were significant (p < 0.05) clinical features, and were more severe in coinfection compared to mono-infections in multivariate analysis.ConclusionThe study shows a high rate of rotavirus and Campylobacter coinfection in children with diarrhoea. Diagnosis based management of diarrhoeal cases can guide the specific treatment.
Highlights
Diarrhoea, curable, is a global cause of death for a half million children every year
This study focuses on coinfection of Campylobacter in rotavirus infected children and explores associated risk factors and clinical features
San Diego, USA) for rapid diagnosis of rotavirus, and the samples were taken in the laboratory for the detection of Campylobacter causing infection by culture on Campylobacter blood-free selective agar base supplemented with Campy blood free selective medium (Charcoal cefoperazone deoxycholate agar, CCDA) Selective Supplement (SR0155, containing cefoperazone and amphotericin B antibiotics) (Thermo-Fischer, Oxoid, UK)
Summary
Curable, is a global cause of death for a half million children every year. Rotavirus and Campylobacter are the most common etiological agents of diarrhoea in children less than 5 years of age. The main objective of this study was to determine Campylobacter co-infection associated with rotavirus diarrhoea in children less than 5 years of age. The commonest etiological agents of acute watery diarrhoea in young children in developing countries are rotavirus, enterotoxigenic Escherichia. With the introduction of rotavirus vaccine, the Bhattarai et al BMC Pediatrics (2020) 20:68 number of deaths in children less than 5 years of age declined from 528, 000 in 2000 to 215, 000 in 2013; and decreased the percentage of hospitalization due to acute gastroenteritis caused by rotavirus [6, 7]
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