Effect of Bacterial Diarrhoea on Serum Zinc Levels in Children with Special Reference to Different Bacterial Pathogens: A Cross-sectional Study

Abstract

Introduction: Diarrhoea significantly leads to morbidity and mortality in under-five children, particularly in developing countries. Reduced serum zinc levels in acute non infectious diarrhoea has an impact on the frequency, severity and duration. However, evidence is still evolving on the status of zinc level in bacterial diarrhoea. Aim: To assess serum zinc level in bacterial diarrhoea and compare the serum zinc level in children with the different bacterial pathogens. Materials and Methods: This cross-sectional study was conducted in Department of Paediatrics at Federal Medical Centre, Owerri, Imo State, Nigeria, from August 2015 to February 2016, including 201 children aged 6 to 59 months with diarrhoea. Stool specimens were isolated for bacteria, using conventional culture techniques, while serum zinc levels were determined using atomic absorption spectrometry. Serum zinc level <65 µg/dL was regarded as zinc deficiency. The data collected was analysed using the Statistical Package for Social Sciences (SPSS) version 19.0. Results: Out of 201, 58 (28.9%) of the children with diarrhoea had bacteria in the stool. The most common organism isolated was Escherichia coli (33,16.4%) followed by Salmonella (13, 6.5%). All of the children with positive stool culture, irrespective of the type of microbial agent, had zinc deficiency with significant association between infective diarrhoea and zinc deficiency (χ2 =15.437; p-value=0.004). Children with shigella diarrhoea had the lowest mean serum zinc level, compared to other bacterial agents (33.6±4.4 µg/dL, p-value <0.001). Conclusion: Bacterial pathogens contribute significantly to the cause of diarrhoea in under-five Nigerian children, and are significantly associated with zinc deficiency. Thus, reinforcing the need for zinc supplementation and food fortification programs within the population, and maybe for longer in children with identified bacterial diarrhoea.