Pattern of bacteriological and biochemical profile and determinants of metabolic acidosis among under-fives with diarrheal diseases at the diarrhea treatment and training unit of the University of Calabar Teaching Hospital, Calabar, Nigeria

Objectives: Dehydration and electrolyte derangements are major causes of morbidity and mortality in diarrhea disease. We aimed to evaluate the pattern and determinants of electrolyte derangements and isolates in a stool sample of under-fives with diarrhea at a tertiary hospital in Nigeria. Materials and Methods: This was a prospective and cross-sectional study of 136 under-fives admitted into the diarrheal training and treatment unit who were consecutively recruited. Patients were tested for association using Pearson’s Chi-square, Kruskal–Wallis’ test, and logistic regression modeling. Results: A total of 136 babies were recruited. Three of the stool sample were culture positive for non-specified Escherichia coli, another two grew Entamoeba histolytica. Almost half (n = 56/136, 41.2%) of the children had metabolic acidosis. Predictors of acidosis included severe dehydration (adjOR: 5.76, 95%CI: 1.54–21.50, P = 0.009), ≤3 months breastfeeding (AdjOR 0.39, 95%CI: 0.153–0.997, P = 0.049), and fever (adjOR 6.30, 95%CI: 1.74–22.83, P = 0.005). Conclusion: Metabolic acidosis was common with diarrhea for which exclusive breastfeeding was protective in this study. Although few, the growth of E. histolytica implicates sanitary conditions and suggests the viral origin of diarrhea, hence strongly supports the introduction of rotavirus vaccine in our national routine immunization schedule while proper use of ORS may impact positively on the metabolic complication of diarrheal disease in the tropics.