| dc.description.abstract | Diarrhoea is a major cause of infant morbidity and mortality worldwide. It accounts for
1.6- 2.5 million deaths annually and each child in the developing world experiences an
average of three episodes of diarrhoea per year. Shigella spp and enteroinvassive
Escherichia coli (EIEC) are common etiologic agents of bacillary dysentery. Currently,
conventional culture techniques for identifying Shigella spp from stool has low
sensitivity since the diagnosis is often obscured due to the presence bf low number of
causative organisms, competition from commensals and inappropriate sample collection.
The aim of this study was to determine the prevalence of Shigella and EIEC using
conventional culture method and molecular technique targeting the ipaH gene, common
to both Shigella spp and EIEC. Stool specimens from 440 patients of all ages presenting
to nine health facilities with diarrhoea.were investigated for Shigella species and EIEC by
conventional culture and a subset of the specimens evaluated by molecular technique. Of
the 440 specimens cultured, 48 (10.9%) yielded Shigella species; S. flexneri (56%), S.
dysenteriae non-type 1 (25%), and S. boydii and S. sonnei (8.3% each). No EIEC strains
were isolated. Of the 421 specimens evaluated by PCR, 78 (18.5%) tested positive for
ipaH gene, 331 (78.6%) tested negative, and 12 (2.9%) were weakly positive. All the
Shigella species (100%) isolated by culture and an additional 33 (7.8 %) cases not
identified by culture, were detected by ipaH PCR. Bloody specimens were more likely to
yield a Shigella by culture (56%) and PCR (35%) than other types of diarrhoea (P<0.05).
The findings of this study demonstrate that the magnitude of shigellosis in rural western
Kenya is much higher than previously thought. Information from this study will help in
evaluating the need to strengthen the basic preventing measures and other control
measures against these pathogens. | en_US |
