Clinical features and differential diagnosis of Clostridium difficile-associated diarrhoea in Mali
Clostridium difficile is an enteric pathogen that may cause a wide range of diarrhoeal diseases. While C. difficile is the main causative agent of antibiotic-associated diarrhoea and one of the most important diarrhoeal pathogens in the Western world, little is known about the epidemiology, clinical symptomatology, disease burden and transmission patterns of C. difficile in sub-Saharan Africa, including Mali.
The overall goal of this study, which will be carried out as part of a medical doctoral (M.D.) thesis, is to investigate the occurrence of C. difficile in symptomatic patients with diarrhoea, in healthy controls and in selected animals in Bamako, Mali. Furthermore, the epidemiology of the predominating C. difficile strains, the clinical presentation and potential transmission patterns is analysed.
- To determine the prevalence of C. difficile in patients with diarrhoea (outpatients and inpatients) and in healthy controls
- To identify the distribution of toxigenic strains and non-toxigenic C. difficile strains in Bamako and to elucidate their antimicrobial susceptibility patterns
- To assess the predominant C. difficile ribotypes and to compare these to those of other countries and regions
- To assess the influence of prior antibiotic therapy, prior hospitalisation and frequent co-infections on C. difficile infection
- To compare the C. difficile strains obtained from humans and animals to assess the potential of C. difficile to be transmitted as a zoonotic pathogen
Additionally, the prevalence of colonisation with C. difficile in asymptomatic individuals and selected animal species (e.g. chicken and sheep) as well as the environmental contamination is evaluated.
Swiss TPH: Sören Leif Becker
Institut National de Recherche en Santé Publique: Moussa Sacko