Abstract: Background: Clostridium difficile Associated Diarrhea (CDAD) is considered to be one of the commonest causes of nosocomial diarrhoea worldwide. Gastrointestinal infections in the form of diarrhoea are common in pediatric oncology patients in Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. The study was conducted to find out the frequency of Clostridium difficile infection (CDI) among diarrheal children with haematological malignancy.

Materials and Methods: This prospective observational study was conducted from April 2012 to March 2013 at the Pediatric Hematology and Oncology Unit, BSMMU, Bangladesh. Total 58 diarrheal episodes occurred in 51 children with various types of haematological malignancies were included consecutively. Faecal samples of the children were sent to International Centre for Diarrheal Disease Research, Bangladesh (ICDDR, B) laboratory for detection of Clostridium difficile antigen (GDH) and toxins (A and/ or B) by Enzyme Immunoassay (EIA).

Results: Among 58 diarrheal episodes 22.4% faecal samples were positive for GDH, but none of the faecal samples was positive for toxin A and or B. There were a significant association with leucopenia, severe neutropenia; usage of meropenem plus vancomycin, cefepime plus amikacin, imipenem, cytarabine and omeprazole with GDH positive diarrheal episodes.

Conclusion: Positive GDH antigen with a negative result for toxin indicates C. difficile colonization. Among GDH positive episodes, a significantly higher proportion of children had leucopenia, severe neutropenia and usage of some drugs known as risk factors for C. difficile infection. To confirm the CDI advanced tests are needed.

Keywords:  C. difficile antigen, C. difficile toxins, Neutropenic diarrhoea, Chemotherapy, C. difficile colonization, Proton- pump inhibitor, Health care infection.

Download

Abstract: Introduction: Malnutrition among under-5 year children is a common public health problem and it is one of the main reasons for the death of children in developing countries. About 35% of under-five children’s death is associated with malnutrition globally. There are 165 million stunted, 99 million under-weighted, and 51 million wasted children globally. In Ethiopia, more than half of child deaths are associated with malnutrition. The objective was to assess the prevalence of stunting and associated factors in children of 6-59 months old in central Tigray, Ethiopia.

Methods: A community-based cross-sectional study was conducted in children of 6-59 months of age with a total sample size of 420. Systematic random sampling method was used. Data were coded and entered in the computer using SPSS version 20 Software and world health organization anthropometric version 3.3 was used to convert these nutritional data into Z-scores of the induces. Descriptive summary using frequencies, proportions, graphs and cross tabs is used to present study result. Binary Logistic regression analysis was carried out at two levels to identify factors associated with stunting

Result: The prevalence of stunting is 47% and variables like age of the mother, duration of breastfeeding and the way how to feed the child was the variable that had statistical significantly associated with stunting.

Conclusion: The prevalence of stunting is high and consistent as compared to other studies done in Ethiopia. This indicates that malnutrition among under-five in central Tigray is comparable with other regional states of Ethiopia.

Keywords:  Malnutrition, Stunting, Wasting, underweight, Ethiopia.