An-Najah Staff

Diarrheagenic Escherichia coli (DEC) is one of primary causative organisms of diarrhea. It’s recognized to be the most common cause of endemic and epidemic diarrhea worldwide. This study aim to determine the prevalence of DEC infections and the risk factors included socio-demographic, environmental factors, behavioral habits and complaints related to E. coli among children less than 12 years old in Jenin governorate. Method: Stool samples from 145 children with diarrhea or dysentery (symptomatic) and 170 samples from asymptomatic children (without diarrhea) of both sexes were collected randomly from Governmental health service centers from Jenin governorate. The samples were transported to laboratory within an hour after microscopic examination and inculated on MacConkey agar (MA) and Sorbitol MacConkey agar (SMA). E coli were identified by colony characteristic and standard biochemical tests. DEC groping were done by Multiplex PCR for the suspected E. coli colonies. Family of each child filled a questionnaire regards socio-demographic, environmental factors and behavioral habits of their child. Results: Result showed a total prevalence of 14.3% (45/315) among study population. No significant difference in the prevalence of DEC between symptomatic 15.2 (22/145) and asymptomatic (control) 13.5 (23/170) groups. The most prevalent pathotypes was ETEC (10.2%) followed by EAEC (2.5%) and EHEC (1.5%). The majority of DEC infection isolates (20.1%) were detected in children less than two years old. This result related to beginning of environmental exposure and increased introduction of solid foods to children whose immune system is still developing within the first year of age. Significant association was found between DEC prevalence and the contact with animals and drinking un-boiled or unpasteurized milk. The water source was although associated with the infection, the use of municipal water or boiling water showed a significant reduction prevalence of infection. In addition, our results provide evidence that washing child hands or vegetables before eating, helping mother for child and use of toilet tissues at the bathroom played an important role in decrease rate of infection. Conclusion and Recommendation: The prevalence rate of DEC infection in Jenin area was 14.3%. However this ratio can also be reduced by different way depended on the factors studied in this study. The majority of DEC infection isolates (20.1%) was detected in children less than two years old and mostly found in both diarrheal and control patients without any significant difference. Our society needs a further work to determine the prevalence of DEC among children in Palestine. In addition we can do courses education to educate mothers and children how to use proper hand-hygiene technique, drink pasteurized beverages, eat cooked meat avoid direct contact with animals and wash hands after handling raw meat.