Significant of macroscopic and microscopic detection for diagnosis of bloody diarrhea among children under five years in khartoum state

Objective: To assess the significance of the Integrated Management of Childhood Illness (IMCI) guidelines in diagnosis of bloody diarrhea. Methods: Four hundred and thirty two children patients with diarrhea attending Khartoum Pediatric Hospital and Omdurman Pediatric Hospital Khartoum Sudan were enrolled into the study during the period of 2005 to 2007. Stool specimens collected were processed by wet preparation and cultured into XLD medium, sorbitol MacConkey medium and Skirrow's medium. The suspected pathogenic colonies were tested for oxidase and urease production then identified by analytical profile index (API 20 E), and agglutination with specific antisera. The results: The sensitivity and specificity of gross blood in faeces as diagnostic tools were 61.4% and 60.1% respectively (P<0.05). RBCs were detected in 112 (25.9%) of specimens with positive culture compared with 305 (70.6%) that revealed negative culture. The sensitivity of presence of RBCs in faeces as diagnostic tools were was high 98.2% while its specificity was very low 3%. The sensitivity and specificity of pus cells in faeces as diagnostic tools were high that represent 99.1% and low 4% respectively. Conclusions: Microscopical examination of stool specimen as simple diagnostic tool was high sensitive and its specificity was moderate.