Presentation

1. PREVALENCE OF SOME BACTERIAL AGENTS OF
GASTROENTERITIS AMONG APPARENTLY
HEALTHY NURSERY AND PRIMARY SCHOOL
PUPILS (0-6 YEARS) IN DUTSIN-MA TOWN
BY
ANAS UMAR
SCI/2014/1104
SUPERVISED BY
MR TIMOTHY AUTA
OCTOBER, 2017

2. INTRODUCTION
 Gastroenteritis remains a leading cause of childhood morbidity and
mortality in developing countries including Nigeria (Gimwood,
2012).
 The term “gastroenteritis” is derived from three Greek words
“gastro” meaning “stomach”, “enteron” meaning “intestine” and
“itis” meaning “inflammation”. (Mehta, 2006).
 Causes of gastroenteritis (Dolin et al., 2010).
 Signs and Symptoms ( Lozano, 2012)
 Modes of Transmission (Scallan, 2011)

3. Aim and Objectives
 The study was aimed at investigating the prevalence of some
bacterial agents of gastroenteritis among apparently healthy
nursery and primary school pupils (0-6 years) of age in Dutsin-
Ma metropolis
The objectives of the study were:
 To determine the prevalence of some bacterial agents using
demographic information on study subjects such as sex, age,
school, class of pupils and sources of drinking water using
questionnaire.
 To isolate some bacterial agents of gastroenteritis from stool
samples using culture.
 To identify and characterize isolated bacterial agents using
Gram staining and Biochemical test.

4. METHODOLOGY
 Study Area
 Sample Collection
Sample Analysis :
 Culture (Cheesbrough, 2006)
 Gram Staining
 Biochemical Test ( Cheeserough, 2006)

5. RESULTS
Table 1: Prevalence of bacterial agents in relation to age (0-6 years) and sex of pupils
Age
(yrs) Male Female Total
X2cal. = 12.53; X2tab. 2 (p= 0.05) = 5.99
X2cal. (12.53) > X2tab.(5.99) 2 (p= 0.05); significant difference existed
Key:
No.: Number; %: Percentage ; Yrs= Years
No. examined No. positive %prevalence No.
examined
No. positive % prevalence No.
examined
No. positive % prevalence
0-2 31 12 38.71 27 21 77.78 58 33 56.89
3-5 30 20 66.67 34 7 20.59 64 27 42.19
6-8 21 4 19.05 7 5 71.43 28 9 32.14

6. Table 2: Prevalence of bacterial agents according to sampled schools in Dutsin-ma town
Class Male Female Total
Key:
NS1 = Nursery School One; NS2= Nursery School Two
NS3= Nursery School Three; PS1= Primary School One; PS2= Primary School Two
PS3= Primary School Three; No.=Number ; %=Percent
age
No.
examined
No. positive
%Prevale
nce No.
examined
No. positive
%prevalenc
e
No.
examined
No. positive
%Prevalenc
e
NS1 15 7 46.67 7 5 71.43 22 12 54.55
NS2 4 2 50.00 6 2 33.33 10 4 40.00
NS1 6 5 83.33 4 3 75.00 11 8 72.73
PS3 13 3 23.08 7 4 57.14 20 7 35.00
NS2 9 2 22.22 8 4 50.00 17 6 35.29
NS3 5 4 8.00 11 4 36.36 16 8 50.00
PS1 6 3 50.00 4 1 25.00 10 4 40.00
PS1 8 2 25.00 7 3 42.86 15 5 33.33
NS3 4 3 75.00 6 3 50.00 10 6 60.00
PS3 11 5 45.45 8 4 50.00 19 9 47.37

7. Table 3: Prevalence of bacterial agents as related to source of drinking water based on
responses from questionnaire distributed
X2cal. = 5.51; X2tab.d.f 4 (p= 0.05) = 9.49
X2cal. < X2 tab.; no significant difference
Key:
No.: Number; %: Percentage
Source of drinking water No. Examined No. Positive Prevalence (%)
Tap 4 2 25.00
Well 72 42 57.53
Borehole 55 17 30.91
Packaged water 3 0 0
Mixed sources 15 9 60.00
Total 150 69 46.00

8. Table 4: Morphology, cultural characteristics and Gram stained reaction of Escherichia coli
isolated from faecal samples of pupils
Total 62 28 45.16%
Key:
EMB=Eosin Methylene Blue; Mac.= MacConkey; E. coli= Escherichia coli No.= Number;
%= Per cent; -= negative; PS1=Primary School One
PS3=Primary School Three; NS1=Nursery School One
No.
tested
No.
Positive
Prevalence
(%)
Media
Used
Colonial
Characteristics
Gram
Reaction
Probable
Organism
NS1
PS3
PS1
NS1
8
12
3
12A
4
4
3
6
48.57 Mac. Pinkish,
transparent
medium size
smooth colonies
Gram
negative,
pink
colour
small rods
arranged
singly or
paired
E.coli
PS3
NS2
PS1
NS2
NS2
7
5
6
2
5
2
4
-
3
2
44.74 EMB Green metallic
sheen, medium
size colonies with
dark centre
Gram
negative
pink small
rods singly
arranged
or paired
E.col
i

9. Table 5: Morphology, cultural characteristics and Gram stained reaction of isolated Proteus
spp. from faecal samples of pupils
Total 27 16 59.26%
Key:
Spp.=species
%= Per cent
No.= Number
SSA=Salmonella-Shigella agar; PS1= Primary School One
NS1= Nursery School One; NS2= Nursery School Two
Class No.
Tested
No positive %preval
ence
Media
used
Cultural
characteristics
Gram reaction probable
organism
PS1
NS1
NS2
PS1
NS1
6
5
5
4
7
-
5
2
4
5
SSA Pale coloured,
medium size colonies
with dark centre
Gram negative rods Proteus spp.

10. Table 6: Morphology, cultural characteristics and Gram stained reaction of isolated Shigella
spp. from of pupils’ stool samples
Total 23 13 56.52%
Key:
SSA= Salmonella-Shigella Agar
%= Per cent
No.=Number; Spp.= Species;PS3= Primary School Three;
NS1= Nursery School One; NS2= Nursery School Two
Class No. tested No.
positive %prevalenc
e
Media used Cultural
characteristics
Gram
reaction
Probable
organism
PS3
NS1
NS2
7
7
9
5
5
3
SSA Colourless, small to
large smooth colonies
Gram
negative
short rods
singly
arranged or
in pairs
Shigella spp.

11. Table7: Biochemical characteristics of isolated bacterial agents from pupils’ faecal samples
Key:
+=Positive; -= Negative; += Plus; E. coli=Escherichia coli
A=Acid; Al=Alkaline; G=Gas; H2S=Hydrogen sulphide; F=Fermenter
OF=Oxidative Fermentation; TSI=Triple Sugar Iron; MR=Methyl red;
VP=Voges Proskauers
Citrate Motility MR VP Indole TSI Urea OF Probable
organism
- + + + - A/A + G - - E. coli
+ + + - - Al/A + G +
H2S
- F Proteus
spp.
+ - - + - A/A + G - - Klebsiell
a spp.
+ - + - + Al/A - F Shigella
spp.
+ + - + - A/A + G + - Enterob
acter

12. Discussion
 The study was aimed at investigating the prevalence of some bacterial agents
among apparently healthy nursery and primary school pupils (0-6 years) of age in
Dutsin-ma town.
 The study revealed highest prevalence (56.89%) of bacterial agents among 0-2
year old nursery and primary school pupils followed by 3-5 year olds (42.19%) and
the least prevalence (32.14%) among 6-8 year old children.. This finding disagrees
with that of Odusanya and Tayo, (2001), who reported 37.40% prevalence of
Shigella spp.in children less than five years of age.
 The finding of this study also revealed that Nursery School 1 had highest
prevalence (72.73%) of bacterial agents, while the least prevalence (33.33%) was
observed in Primary School 1. This result disagrees with the work of Webber,
(2013), who reported that gastroenteritis might occur via consumption of
contaminated water, food or when people share personal objects.
 It showed that no significant difference existed between different water sources
used in the schools. Mixed water sources had highest prevalence (60.00%) of
bacterial agents followed by well water (57.53%).
 The second high prevalence was recorded in well water. This agrees with the
report of Jaranet, (2005 ), who reported that well water could be contaminated
with material released directly into it or with faecal materials from humans or
animals.

13. Discussion Cont’d.
 The study revealed 45.16% prevalence of E.coli among the study participants. This
finding disagrees with the report of Clarke (,2001) that stated that the bacterial
pathogen most commonly associated with endemic forms of childhood diarrhoea
is Escherichia coli which might be due to mixed infections with other microbes.
 Highest prevalence (59.26%) of Proteus was recorded among nursery 1 and 2,
and primary 1 pupils of the sampled schools . This might be due to consumption
of raw or undercooked food containing Proteus. This finding contradicts the
finding of Kadanchi, (2010 ) whose reported the prevalence of 72.45% of Proteus
in Akwaibom, Nigeria.
 The study also showed the prevalence of Shigella spp. (56.52%) among nursery 1
and 2, as well as primary 1 school children of the sampled schools. This finding is
in agreement with that of Dolin et al., (2010) that reported 57.05% prevalence of
gastroenteritis due to Shigella.
 The biochemical tests carried out on the isolated agents in this study revealed
the occurence of 5 different bacterial agents in the samples which were
presumptively identified and characterized to be E.coli, Proteus spp., Shigella
spp., Enterobacter spp. and Klebsiella spp., respectively.

14. Conclusion
 In conclusion, bacterial agents are associated with gastroenteritis among
apparently healthy school children (0-6 years) in Dutsin-Ma town.
 Out of the 150 faecal samples analysed, 69(46.0%) yielded positive growth of
bacteria.
 A total of 5 different bacterial species were isolated and presumptively identified as
Escherichia coli 28(45.16%), Proteus 16(59.26%), Enterobacter spp. 10(41.67%),
Shigella spp. 13(56.52%) and Klebsiella spp. 4(25.0%), respectively.
 The prevalence of the agents was highest (56.89%) among 0-2 year old pupils and
least prevalent (32.14%) among 6-8 year old pupils.

15. Recommendations
Based on the findings of this study, the following recommendations
were hereby made:
Hand washing should be encouraged in nursery and primary schools.
People, especially parents should practice good personal, water and
food hygiene including boiling water obtained from sources such as
rivers, dams or well before use.
Avoid eating undercooked foods.
 Eating places of the children should be sanitized regularly.

16. Selected References
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Clarke, S. C. (2001). Diarrhoeagenic Escherichia coli among young children. An emerging
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Douglas, and Bennett's Principles and Practice of Infectious Diseases (7th ed.).
Philadelphia, PA: Churchill Livingstone/Elsevier Press. ISBN 0-443-06839-9. 45-49p.
Grimwood, K. and Forbes, D.A. (2012). Acute and persistent diarrhoea. Treatment
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Webber, T. Roger, W. (2009). Communicable Disease Epidemiology and Control : A Global
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