title: Prevalence and determinants of Campylobacter infection among under five children with acute watery diarrhea in Mwanza, North Tanzania.
abstract: BACKGROUND
  Campylobacteriosis, a zoonotic bacterial disease observed world-wide, is becoming the most commonly recognized cause of bacterial gastroenteritis in humans. This study was done to determine the prevalence and determinants of Campylobacter infection among under-fives with acute watery diarrhea in Mwanza City, Tanzania.
  
  
  METHODS
  This cross-sectional hospital-based study was conducted at Bugando Medical Centre (BMC) and Sekou Toure Hospital in Mwanza City. All inpatients and outpatients under-fives who met the inclusion criteria from October 2012 to April 2013 were enrolled in the study. Demographic and clinical data were obtained using standardized data collection tools. Stool samples were collected for gram staining and culture for Campylobacter spp. on Preston selective agar media. In addition, blood slides for malaria and HIV tests were done to all patients.
  
  
  RESULTS
  A total of 300 children were enrolled with a median age of 12 [interquartile range, 8-19] months. Of these, 169 (56.5%) were from BMC and 131 (43.7%) from Sekou-Toure hospital. One hundred and seventy (56.7%) of the participating children were male. Of 300 under-fives with acute watery diarrhea, 29 patients (9.7%) were found to have Campylobacter infection. A significant higher number of children with Campylobacter infection were found in Sekou Toure hospital compared to BMC [16.0% (21/29) versus 4.7% (8/29), p = 0.002)]. Age above 2 years was independently found to predict campylobacter infection (OR: 2.9, 95% CI 1.1-7.7, p = 0.0037). Of 30 patients with a positive blood slide for Plasmodium falciparum, 20.0% were also positive for Campylobacter infection (OR: 3.9, 95% CI 1.2-10.1, p = 0.021).
  
  
  CONCLUSIONS
  Campylobacter infection shows a comparatively low prevalence in under-fives with acute watery diarrhea in Mwanza city and is independently associated with positive slides for malaria and an age above 2 years. Further studies are needed to type the most prevalent Campylobacter species and to determine their antibiotic susceptibility pattern.
authors.affiliation: Department of Pediatrics and Child health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
authors.forename: Anna-Pendo
authors.initials: AP
authors.lastname: Deogratias
authors.affiliation: Department of Microbiology/Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
authors.forename: Martha F
authors.initials: MF
authors.lastname: Mushi
authors.affiliation: Department of Microbiology/Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
authors.forename: Laurent
authors.initials: L
authors.lastname: Paterno
authors.affiliation: Institute of Hygiene and Microbiology, University of Wuerzburg, Wuerzburg, Germany.
authors.forename: Dennis
authors.initials: D
authors.lastname: Tappe
authors.affiliation: Department of Microbiology/Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Seni
authors.affiliation: Department of Pediatrics and Child health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
authors.forename: Rogatus
authors.initials: R
authors.lastname: Kabymera
authors.affiliation: Department of Biochemistry and Molecular Biology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
authors.forename: Benson R
authors.initials: BR
authors.lastname: Kidenya
authors.affiliation: Department of Microbiology/Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Mshana
keywords: Acute watery diarrhea; Campylobacteriosis; Under five children