Prevalence of Enteric Bacteria Pathogens among HIV Infected and Uninfected Children in Dandora, Kenya

Background: Diarrhoea is the second disease killer after respiratory diseases in children. Globally, there are nearly 1.7 billion cases of diarrheal disease every year. In developing countries, enteric bacterial pathogens are most common causes of morbidity and mortality in children especially under 5 years. Most of the studies done on enteric bacteria pathogens and HIV co-infection have focused on the children less than 5 years of age but not above.

Objective: This study aimed at evaluating the distribution of common circulating enteric bacterial pathogens; Escherichia (E).coli, Shigella, and Salmonella among HIV infected (n=79) and uninfected (n=78) children aged 5-12 years from Dandora slums of Nairobi.

Methods: This was analytic cross-sectional study of HIV positive children enrolled at Nyumbani Lea Toto HIV/AIDS outreach program in Dandora, while HIV negative are children from same area (preferably sibling). Stool samples were collected from consenting participants and sent to Microbiology laboratory in Kenya Medical Research institute for processing. The samples were cultured using differential media for enteric bacteria. Suspected isolates were further identified using conventional biochemical methods and serology. Multiplex PCR was done on E. coli isolates to detect virulence factors responsible for different E. coli pathotypes.

Results: The overall prevalence of pathogenic Escherichia coli, Shigella and Salmonella was 44 (28%), 31 (19.7%) and 0 (0.0%) respectively. Enteroaggregative E.coli (43.2%) was the main E. coli pathotypes observed. Distribution of pathogenic E. coli in HIV infected and uninfected was 12.7% and 15.3%, respectively (p = 0.30), while that of Shigella was 6.4% and 13.4% (p = 0.03).

Conclusion: From this study HIV infected children had less infestation of Shigella species as compare to HIV uninfected children, which could be due to constant treatment for any infections thus interferes with bacteria grow.