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Microbial aetiology of diarrhea in children less than five years of age at tertiary care hospital of Western Uttar Pradesh, India

Introduction and Aim: Diarrhoeal diseases are one of the major causes of childhood morbidity and mortality globally. Multiple aetiologies and associated risk factors are responsible for diarrhoeal diseases in children. The present study aims to determine the microbial aetiology and possible risk factors of diarrhoea in children less than five years of age at Chhatrapati Shivaji Subharti Hospital, Subharti Medical College, Meerut in Western Uttar Pradesh, India. 
  
Materials and Methods: A total of 240 children < 5 years of age with history of acute diarrhoea of less than 7 days duration were included in the study. Microbial etiology of diarrhoea in children were looked for. Bacterial etiology was identified by standard bacteriological technique. Diarrheagenic E. coli (DEC) were identified by gene-specific polymerase chain reaction. Rotavirus (RV) antigen was detected by Enzyme Immunoassay (EIA), parasites were identified by wet mount preparation and fungal etiology was identified by microscopy and culture on Sabouraud’s Dextrose Agar. 
  
Results: Out of 240 stool samples, 152 were identified as known aetiology of diarrhea. Microbial etiology could be established in 133/240 (55.41%) stool samples. The most common microbial etiology was bacterial 63(47.36%) followed by rotavirus 35 (17.29 %), parasitic etiology in 22 (16.54%) and least common etiology was fungal in 13 (9.77%) cases. Among other etiology, Lactose intolerance was found in 19/240 (7.91%) cases. Mixed aetiology with two or more pathogen causing diarrhoea was seen in 27% cases. 
  
Conclusion: Aetiological agents of diarrhoea could be identified in 63.3% cases. Causes of childhood diarrhoea is polymicrobial and preventable. Awareness and education especially to the mothers regarding the disease, safe drinking water, proper food intake and proper sanitation are key to overcome the burden of the preventable infectious diseases among children less than five years of age.