Distribution of Colonization Factors and Toxins among Diarrheal Children below 5Years: A Case Study of Moi Teaching and Referral Hospital, Kenya

Estimates suggest that approximately 200 million cases and 380, 000 deaths occur in children below 5 years of age due to Enterotoxigenic Escherichia coli (ETEC) infections annually. The study aimed at molecular determination of ETEC toxins and colonization factors distribution among children below 5 years of age. Multiplex PCR was used in the identification of ETEC toxin and colonization factors. A total of 200 isolates of E. coli-like recovered from diarrheic children at Moi Teaching and Referral Hospital were collected and transported to Microbiology Hub Walter Reed Project-Kericho and tested for the presence of virulent factors using Multiplex PCR method. Positive isolates for ETEC were subjected to a panel of colonization factor antigens (CFA) using multiplex PCR for identification of colonization factors. Data was analyzed using statistical analysis system (SAS) and fishers exact test was used for comparing 2 variables. Heat labile toxins (LTh) were more common (65.38 %) than heat stable toxins (STh) (26.92 %). LTh ETEC toxins were observed in younger and older children (42.3 % and 23.08 % respectively) while STh ETEC toxins were more frequent in children below 2 years and were not observed in children above 2 years old. The most common colonization factor was coli surface antigens 6 (Cs6) and coli surface antigens 1 (Cs1) and was detected in children below 2 years of age. STh and LTh ETEC toxins had a detectable Colonization factor at higher frequency (19.23 %). Children below 5years are susceptible to ETEC toxins and CFs. Use of molecular diagnostic technique to determine the distsribution of ETEC toxins and CFs should be adopted.