Factors associated with Salmonella infection in patients with gastrointestinal complaints seeking health care at Regional Hospital in Southern Highland of Tanzania

Abstract

Background: Salmonellosis remains an important public health problem globally. The disease is among the leading causes of morbidity and mortality in developing countries that experience poor hygiene and lack of access to clean and safe water. There was an increase in reported cases of Salmonellosis in Njombe Region, Southern Highland of Tanzania between 2015 and 2016 based on clinical diagnosis. Nevertheless, little is known about the factors contributing to the transmission of this disease in the region. This study was conducted to determine the prevalence, antimicrobial susceptibility, and factors associated with Salmonella infection among patients who report gastrointestinal complaints. Methods: A cross-sectional study was conducted from December 2017 to February 2018 among patients with gastrointestinal complaints at Kibena Regional Hospital. Stool samples were submitted for isolation of Salmonella spp. Identification was based on conventional biochemical tests and serotyping to differentiate typhoid and nontyphoid Salmonella (NTS). Antimicrobial susceptibility was performed using the Kirby-Bauer disc diffusion method. Multivariable logistic regression analysis was performed to examine the factors independently associated with Salmonella infection. Results: The prevalence of Salmonella infection among participants with gastrointestinal complaints was 16.5% (95% CI: 12.7-21.1) of them, 83.7, 95% CI: 70.9-91.5 were NTS while 16.3, 95% CI: 8.5-29.0 were Typhoid Salmonella species. All isolates were sensitive to ceftriaxone and ciprofloxacin, whereas 27.8 and 100% were resistant to co-trimoxazole and ampicillin respectively. The odd of Salmonella infection was fourfold higher among participants with formal employment (AOR 3.8, 95% CI, 1.53-9.40). Use of water from wells/rivers (AOR 2.2, 95% CI, 1.07-4.45), drinking untreated water (AOR 2.6, 95% CI, 1.21-5.48) and often eating at a restaurant (AOR 3.4, 95% CI, 1.28-8.93) had increased odds of Salmonella infection. Likewise, having abdominal pain (AOR 8.5, 95% CI, 1.81-39.78) and diarrhea (AOR 2.3, 95% CI, 1.12-4.68) were independent symptoms that predict Salmonella infection. Conclusion: There is a high prevalence of Salmonella infection among people who report gastrointestinal complaints and it is clinically predicated by diarhoea and abdominal pain. Employed participants and those eating at restaurant and drinking unsafe water had higher risk of infection. Salmonella spp. causing gastroenteritis has developed resistance to commonly used antibiotics.

Prevalence, Serotype Distribution and Antimicrobial Resistance of Non-Typhoidal Salmonella in Hospitalized Patients in Conghua District of Guangzhou, China

“…In the present study, 20.39% (52/255) of hospitalized patients of a large hospital in the north-east of Guangzhou City were confirmed to be infected with NTS. The present prevalence was higher than that of the previous reports in patients with gastrointestinal complaints of 13.80% (41/297) in Tanzania (Ngogo et al, 2020) and 6.2% (59/957) in Ethiopia (Eguale et al, 2015), as well as in pet caregivers of 17.86% (25/140) in Thailand (Wu et al, 2020). The variation between studies on Salmonella infection could be due to multiple factors, such as differences of enrolled patient characteristics (gender, age and residence), time of sample collection (seasonal variation), and possible risk factors (Ngogo et al, 2020).…”

“…Salmonella infection is a major public health concern worldwide, in both industrialized and developing countries, has contributed to an increased economic burden on the health systems. Non-typhoidal Salmonella (NTS) is a common cause of bacterial enteritis in humans, causing 93.8 million cases of gastroenteritis globally each year, with 155,000 deaths (Ngogo et al, 2020).…”

Role of ultrasound and CT in the early diagnosis and surgical treatment of primary sternal osteomyelitis caused by Salmonella: Case reports

“…However, not all infants with Salmonella infection develop a clinical manifestation of PSO. It may be associated with non-identification of the etiology of the infection and nonreceipt of effective anti-infective therapy in the early stages of infection, as parents of the infants in the present case report recalled that there was an absence of common symptoms of Salmonella infection, including gastrointestinal complaints and diarrhea ( 8 ). However, whether this condition occurs as a result of a particular Salmonella strain requires further study and observation.…”

Virulence and Antibiotic Resistance Profiles of Salmonella Isolated from Chicken Ready Meals and Humans in Egypt

“…Insignificant sex risk factor was found in the current study despite the difference in the infection rate between males and females as 14.67, 8 and 4.76 and 10.34% in food handlers and patients, respectively. Compatible results were achieved by Mengist et al (2018) and Ngogo et al (2020). This can be explained by the fact that the incidence of infection increases with increased contact with food either among food handlers or patients.…”