Surveillance of Bacterial Pathogens of Diarrhoea in Two Selected Sub Metros Within the Accra Metropolis.
BACKGROUND
In recent years, many localities within the Greater Accra Region (GAR) have witnessed several episodes of cholera outbreaks, with some deaths. Compared to previous epidemics, which usually followed heavy rains, recent outbreaks show no seasonality.


OBJECTIVE
To investigate infective bacterial diseases in selected sub metros within the GAR.


METHODS
We used existing disease surveillance systems in Ghana, and investigated all reported cases of diarrhoea that met our case-definition. A three-day training workshop was done prior to the start of study, to sensitize prescribers at the Korle-Bu Polyclinic and Maamobi General hospital. A case-based investigation form was completed per patient, and two rectal swabs were taken for culture at the National Public Health and Reference Laboratory. Serotyping and antibiogram profiles of identified bacteria were determined. Potential risk factors were also assessed using a questionnaire.


RESULTS
Between January and June 2012, a total of 361 diarrhoeal cases with 5 deaths were recorded. Out of a total of 218 rectal swabs cultured, 71 (32.6%) Vibrio cholerae O1 Ogawa serotypes, and 1 (0.5%) Salmonella (O group B) were laboratory confirmed. No Shigella was isolated. The Vibrio cholerae isolates were susceptible to ciprofloxacin and tetracycline. Greater than 80% of patients reported having drank sachet water 24 h prior to diarrhoea onset, and many (144/361) young adults (20-29 years) reported with diarrhoea.


CONCLUSIONS
Enhanced surveillance of diarrhoeal diseases (enteric pathogens) within cholera endemic regions, will serve as an early warning signal, and reduce fatalities associated with infective diarrhoea.
Disease Surveillance Department, Ghana Health Service, Accra Ghana.
E K
EK
Dzotsi
National Public Health and Reference Laboratory.
A Z
AZ
Dongdem
National Public Health and Reference Laboratory.
G
G
Boateng
National Public Health and Reference Laboratory.
L
L
Antwi
National Public Health and Reference Laboratory.
G
G
Owusu-Okyere
National Public Health and Reference Laboratory.
D B
DB
Nartey
Department of Microbiology, University of Ghana Medical School, P. O. Box 4236, Accra, Ghana.
M
M
Olu-Taiwo
Disease Surveillance Department, Ghana Health Service, Accra Ghana.
M J
MJ
Adjabeng
Disease Surveillance Department, Ghana Health Service, Accra Ghana.
J
J
Amankwa
Disease Surveillance Department, Ghana Health Service, Accra Ghana.
B
B
Sarkodie
Disease Surveillance Department, Ghana Health Service, Accra Ghana.
J
J
Addo
Greater Accra Regional Health Directorate, Ghana Health Service, Accra, Ghana.
E
E
Antwi
National Public Health and Reference Laboratory.
E
E
Aryee
Department of Microbiology, University of Ghana Medical School, P. O. Box 4236, Accra, Ghana.
J A
JA
Opintan
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002771:Cholera / Q000453:epidemiology*; D003967:Diarrhea / Q000453:epidemiology*; D004196:Disease Outbreaks; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011159:Population Surveillance; D011634:Public Health; D012475:Salmonella / Q000302:isolation & purification*; D041241:Vibrio cholerae O1 / Q000302:isolation & purification*; D055815:Young Adult
D000900:Anti-Bacterial Agents
Diarrhoeal disease surveillance; Salmonella; Vibrio cholerae; enteric pathogens