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Surveillance of bacterial pathogens of diarrhoea in two selected sub metros within the Accra metropolis

EK Dzotzi
AZ Dongdem
G Boateng
L Antwi
G Owsu-Okyere
DB Nartey
M Olu-Taiwo
MJ Adjabeng
J Amankwa
B Sarkodie
J Addo
E Antwi
E Aryee
JA Opintan


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.
Objectives: 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.
Conclusion: 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.

Keywords: Diarrhoeal disease surveillance, enteric pathogens, Vibrio cholerae, Salmonella