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Am. J. Trop. Med. Hyg., 76(3), 2007, pp. 522-527
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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ETIOLOGY OF DIARRHEA IN CHILDREN YOUNGER THAN 5 YEARS OF AGE ADMITTED IN A RURAL HOSPITAL OF SOUTHERN MOZAMBIQUE

INÁCIO M. MANDOMANDO*, EUSÉBIO V. MACETE, JOAQUIM RUIZ, SERGI SANZ, FATIMA ABACASSAMO, XAVIER VALLÈS, JAHIT SACARLAL, MARGARITA M. NAVIA, JORDI VILA, PEDRO L. ALONSO, AND JOAQUIM GASCON
Centro de Investigação em Saúde da Manhiça, Moçambique; Instituto Nacional de Saude, Ministerio de Saude, Maputo, Mozambique; Centro de Salud Internacional, IDIBAPS, Hospital Clinic, Barcelona, Spain; Direcção Nacional de Saúde, Moçambique; Faculdade de Medicina, Universidade Eduardo Mondlane, Moçambique; Servei de Microbiologia, IDIBAPS, Hospital Clinic, Barcelona, Spain

Diarrhea is one of the main causes of morbidity and mortality among children in sub-Saharan Africa and one of the main causes of hospital admissions in rural areas. Stool samples were collected from 529 children admitted with diarrhea to the Manhiça District Hospital (September 2000 to September 2001) and processed to detect bacterial enteropathogens, parasites, and virus. Diarrheagenic Escherichia coli, isolated from 120 samples (22.6%; enteropathogenic [9.6%], enterotoxigenic [6.8%], enteroaggregative [4.3%], and verotoxigenic [1.9%]) was the most frequently isolated pathogen, followed by Ascaris lumbricoides (9.3%). Others detected included Salmonella spp. and Giardia lamblia (2.5% each) and Campylobacter spp. (1.7%). A. lumbricoides (92% versus 8%; P < 0.001) and Strongyloides stercolaris (100% versus 0%; P = 0.008) were most frequently isolated in children older than 12 months of age. Resistance to trimethoprim-sulphametoxazole and ampicillin was high. Etiologic data on diarrheal diseases and susceptibility patterns of diarrheal pathogens are important tools for clinical management and control strategic planning.

Received January 25, 2006. Accepted for publication November 28, 2006.

Acknowledgments: The authors thank the parents and guardians of study participants and the Manhiça Health District Authorities. The authors thank Mariano Sitaúbe for processing the samples. This project was supported by grants from "Agencia Española de Cooperacion Internacional (AECI) and Fundació Clinic de Barcelona (Hospital Clinic de Barcelona). The Centre de Salud Internacional (CSI) receives economical support from RICET and RCESP networks. J.R. has a fellowship from RICET.

* Address correspondence to Inacio M. Mandomando, Manhiça Health Research Centre, Street N12, Manhiça Village, C.P. 1929 Maputo, Mozambique. E-mail: inacio.mandomando{at}manhica.net

Authors’ addresses: Inácio M. Mandomando, Eusébio Macete, Fatima Abacassamo, Xavier Vallès, and Jahit Sacarlal, Manhiça Health Research Centre, Street N12, Manhiça Village, C.P. 1929 Maputo, Mozambique, Telephone: 258-21-810-002, Fax: 258-21-810-181, E-mails: inacio.mandomando{at}manhica.net, eusebiomacete{at}yahoo.com, fabacassamo{at}yahoo.com.br, xavier.valles{at}mesvilaweb.com, and jahitash2002{at}yahoo.com. Joaquim Ruiz and Joaquim Gascon, Secció de Medicina, Tropical Centre de Salut Internacional, Hospital Clinic Rosello 132, 2, 2, 08036 Barcelona, Spain, E-mails: joruiz{at}clinic.ub.es and jgascon{at}clinic.ub.es. Sergi Sanz and Pedro Alonso, Unidad de Bioestadistica, Centre de Salut Internacional, C/Rosello 132, 2, 2, Barcelona 08036, Spain, E-mails: ssanz{at}clinic.ub.es and palonso{at}clinic.ub.es. Margarita M. Navia, Centre de Salut Internacional, C/Rossello 132, 2, 2, Barcelona 08036, Spain, E-mail: mnavia{at}pcb.ub.es. Jordi Vila, Servei de Microbiologia, Hospital Clinic, C/ Villarroel 170, 08036 Barcelona, Spain, E-mail: jvilaestape{at}yahoo.com.




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Copyright © 2007 by the American Society of Tropical Medicine and Hygiene.