Molecular Detection and Epidemiology of Shiegella Spp. and Enterotoxigenic Escherichia Coli (ETEC) Infections Among Children with Acute Gastroenteritis in Accra, Ghana

Abstract

Background: Diarrhoea remains an important public health problem and is the second leading cause of mortality and morbidity in children throughout the world, especially in developing countries. In Ghana, diarrhoea is the third common cause of hospital attendance of young children. It is responsible for 13.1% of hospitalizations among these children and an annual average of 5, 193 deaths in children under 5 years of age. Bacterial enteropathogenic agents of diarrhoea and mechanisms responsible for disease pathogenesis are generally known. However, knowledge on the true prevalence and contribution of these bacteria to the disease burden is very limited. This study strives to optimize available PCR methods to facilitate accurate diagnosis of Enterotoxigenic E. coli and Shigella spp. infections and contribute baseline information on diarrhoeal bacterial enteropathogens. Main Objective: To provide a new method for the routine screening and detection of Enterotoxigenic E. coli and Shigella spp. in diarrhoeal stool samples via PCR. Design: Two hundred archived stool samples from previous diarrhoeal surveillance study were retrieved from the Department of Electron Microscopy/Histopathology of Noguchi Memorial Institute for Medical Research for analysis. Total DNA was extracted and conventional PCR used to identify Enterotoxigenic E. coli (ETEC) and Shigella spp.. The incidence and prevalence was then computed. Results: 4 (2%) samples screened were positive for heat-labile toxin producing ETEC with all detections occurring in the 0-12 month year group. Heat-stable toxin producing ETEC and Shigella were not detected. Conclusion: The overall prevalence of ETEC-LT in this study was 2%. Conventional PCR may be used for the routine screening of diarrhoeal stool samples for ETEC-LT, ETEC- ST, and Shigella. This method of screening diarrhoeal stool samples is fast and specific. Taking into account the promptness with which results are made available for health care delivery and management, this method can be said to be relatively cheaper in comparison to the gold standard, culturing.