Background: Infectious diarrhea is a common cause of mortality and morbidity in developing countries.
World Health Organization attributes 3.5 million deaths a year to diarrhea, with 80 percent of these deaths
occurring in children under the age of five, and most occurring in children between six months and three
years of age. The predisposing factors are mainly due to poor hygiene and most of the cases can be
treated using drugs and supportive measures. Prevention is the main intervention strategy used to prevent
this disease.
Objective: The main objective was to assess the factors that predispose children to diarrhea. The specific
factors assessed were prevalence of bacteria, protozoa, and helminthes, antimicrobial susceptibility of
bacteria, risk factors and management of diarrhea.
Methods: A cross section research design was used and target population was children suffering from
diarrhea and accompanied by their guardians who visited KNH to seek treatment. Three hundred and
eighty four children were selected for the study using simple random sampling. Data was collected using a
questionnaire and stool specimens analyzed in microbiology and parasitology laboratories of Kenyatta
National Hospital. The analysis of data was done using SPSS and data summarized in tables and charts.
Both inferential and descriptive statistics were derived using chi square and confidence intervals.
Results: Majority of the children were between 6-12 months of age and there were more males than
females. The average duration of diarrhea was 4.55 days and majority had suffered from the disease
before. Most of the parents had a certain level of formal education. The fathers had a source of income but
most of the mothers were either self employed or not employed at all. Tap water and toilet facilities were
available to most families and about half of the children had malnutrition.
No organisms were found from the stools of 80.2% of the children. The pathogens isolated were Giardia
lamblia, Entamoeba histolytica, Balantidium coli, Cryptosporidium petvum, Entamoeba coli, Blastocystis
hominis, Endolimax nana, Chilomastix mesnili, Trichiuris trichiura, Salmonella typhi and Salmonella
paratyphi. Bacteria isolated were sensitive to Ciprofioxacin and Levofioxacin but resisted most of the other
drugs tested.
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The risks found to be associated with diarrhea were overcrowding, inadequate hand washing methods,
mixed feeding, none or low level of education of the mother and administration of antibiotics. Majority of the
children had concurrent illnesses and the most common were pneumonia, meningitis, malaria, rickets and
malnutrition. Drugs were mainly prescribed to treat concurrent diseases. The most commonly prescribed
drugs were Zinc Sulphate, Paracetamol, Benzyl penicillin G, Gentamicin, Metronidazole, Multivitamin, Coamoxiclav,
Cefuroxime and Calcimax. ORS was most frequently used fluid and the intravenous ones
included Ringers lactate, Darrows solution, 5% Detrose, Hartmans solution, normal saline and Rehydration
salt for the malnourished.
Conclusion
Only a small proportion of diarrhea in children was caused by intestinal protozoa, helminthes or bacteria.
Majority of the cases occurred during weaning and rehydration was the comerstone of diarrhea
management Most of the drugs used were mainly for treating concurrent illnesses.
Recommendation
Mothers should be taught how to wean children especially on the type of food to use. They should also be
educated on proper hygienic practices especially washing of hands. Bottle feeding should be discouraged
and rational use of antibiotics encouraged
