Epidemiology of bacterial Septicemia among children under five in Mbita Subcounty, South Nyanza, Kenya

Abstract

Background: Septicaemia is a major cause of mortality and morbidity, especially in sub-Saharan Africa leading to complications marked by bodily inflammation referred as sepsis. This is a systemic disease associated with presence of pathogenic microorganisms (viral, parasitic and bacterial) or their toxins in the blood. Bacterial septicaemia is the most fatal and prevalent in hospitalised cases. Globally, 76% of children under five years die due to septicaemia. In East Africa a mortality rate of 40% have been reported. In Kenya, South Nyanza regions have reported higher morbidity and mortality cases among children. We hypothesis that apart from immunosuppressive diseases, septicaemia could contribute significantly to this prevalence in the region.

Methods: Blood samples were obtained from 248 children whose guardian consented and a detailed sociodemographic questionnaire was administered. Bacterial isolation and characterization were done using the automated BACTEC 9240 system.

Results: The mean age of the participants was 27.9 (SD ±20.7) months. The majority (30.6%) were aged between 1 to 12 months, 50.8% were males, 58.9% had body temperatures above 37.6 ^OC while only 8.1% were HIV seropositive. The mean white blood cells (WBC) of the participants were 17720.9 (SD 8929.1) cells/ml with 5.2% had leucopenia. A total of 84 of the 248 (33.9%) of the children had septicaemia with the majority (28.6%) caused by Staphylococcus epidermidis followed by Staphylococcus aureus and Escherichia coli each at 13.1%. Bacteria that were reported singly included Salmonella Paratyphi B, Citrobacter freundii, Gemella morbillorum, Klebsiella pneumoniae, Lactococcus lactis cremoris, Pantoea spp, and Pseudomonas putida. In multivariate regression analysis, female gender (OR 0.6; 95% confidence interval (CI) 0.4 to 0.9), co-infection with malaria (OR 2.7; 95% CI 1.1 to 6.7) and

gastrointestinal disorders (OR 2.9, 95% CI 1.3 – 7.3) were independently associated with bacterial septicemia infection.

Conclusion: Significantly higher proportion of the children in this region are infected with septicaemia. Majority of the cases were caused by Gram positive bacteria. Age and other c-infection contribute significantly to septicaemia infection in this region. Rapid testing and etiological characterisation of children with suspected symptoms of septicaemia is key in this region in order to institute appropriate treatment and management.

Keywords: bacterial Septicemia, Epidemiology, Children under five, South Nyanza, Kenya

DOI: 10.7176/JNSR/10-10-06

Publication date:May 31^st 2020