The Relationship Between Invasive Nontyphoidal<i>Salmonella</i>Disease, Other Bacterial Bloodstream Infections, and Malaria in Sub-Saharan Africa

Park, Se Eun; Pak, Gi Deok; Aaby, Péter; Adu‐Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Biggs, Holly M.; Bjerregaard-Andersen, Morten; Breiman, Robert F.; Crump, John A.; Espinoza, Ligia María Cruz; Eltayeb, Muna Ahmed; Gasmelseed, Nagla; Hertz, Julian T.; Im, Justin; Jaeger, Anna; Kabore, Leon Parfait; Kalckreuth, Vera von; Keddy, Karen H.; Konings, Frank; Krumkamp, Ralf; MacLennan, Calman A.; Meyer, Christian G.; Montgomery, Joel M.; Niang, A; Nichols, Chelsea; Olack, Beatrice; Panzner, Ursula; Park, Jin Kyung; Rabezanahary, Henintsoa; Rakotozandrindrainy, Raphäel; Sampo, Emmanuel; Sarpong, Nimako; Schütt-Gerowitt, Heidi; Sooka, Arvinda; Soura, Abdramane; Sow, Amy Gassama; Tall, Adama; Teferi, Mekonnen; Yeshitela, Biruk; May, Jürgen; Wierzba, Thomas F.; Clemens, John D.; Baker, Stephen; Marks, Florian

doi:10.1093/cid/civ893

Cited by 66 publications

(65 citation statements)

References 39 publications

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“…During surveillance of invasive Salmonella infections that was conducted during the same period at these study sites, 3 of 7 (43%) of iNTS isolates in GuineaBissau and 2 of 3 (67%) of iNTS isolates in Senegal were also identified as other Salmonella serotypes [49]. Further serotyping and genetic analysis of Salmonella excreters in the general population could allow for inference to incident iNTS cases as well as infections causing less-severe diarrheal disease, although this was beyond the scope of the present study.…”

Section: Discussionmentioning

confidence: 99%

Prevalence ofSalmonellaExcretion in Stool: A Community Survey in 2 Sites, Guinea-Bissau and Senegal

Nichols

Bjerregaard-Andersen

et al. 2016

Clin Infect Dis.

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Section: Discussionmentioning

confidence: 99%

Prevalence ofSalmonellaExcretion in Stool: A Community Survey in 2 Sites, Guinea-Bissau and Senegal

Nichols

Bjerregaard-Andersen

et al. 2016

Clin Infect Dis.

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Section: Introductionmentioning

confidence: 99%

“…[2–6] The multicenter Typhoid Fever Surveillance in Africa Program (TSAP) study concluded that malaria is associated with a 5 times higher odds of iNTS disease. [6] A number of studies have highlighted the high health burden of iNTS in children, frequently associated with malaria and malnutrition. [3,5] Much work has also focused on microbiological aspects of iNTS, including serotype and multidrug resistance (MDR), [4,5] or iNTS disease burden.…”

Section: Introductionmentioning

confidence: 99%

Clinical and microbiological features of invasive nontyphoidal Salmonella associated with HIV-infected patients, Gauteng Province, South Africa

Keddy

Musekiwa²,

Sooka

et al. 2017

Medicine

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The aim of this study was to define factors associated with HIV-infected versus uninfected patients with invasive nontyphoidal Salmonella (iNTS) and factors associated with mortality, which are inadequately described in Africa.Laboratory-based surveillance for iNTS was undertaken. At selected sentinel sites, clinical data (age, sex, HIV status, severity of illness, and outcome) were collected.Surveillance was conducted in Gauteng, South Africa, from 2003 to 2013. Clinical and microbiological differences between HIV-infected and uninfected patients were defined and risk factors for mortality established.Of 4886 iNTS infections in Gauteng from 2003 to 2013, 3106 (63.5%) were diagnosed at sentinel sites. Among persons with iNTS infections, more HIV-infected persons were aged ≥5 years (χ2 = 417.6; P < 0.001) and more HIV-infected children were malnourished (χ2 = 5.8; P = 0.02). Although 760 (30.6%) patients died, mortality decreased between 2003 [97/263 (36.9%)] and 2013 [926/120 (21.7%)]. On univariate analysis, mortality was associated with patients aged 25 to 49 years [odds ratio (OR) = 2.2; 95% confidence interval (CI) = 1.7–2.7; P < 0.001 and ≥50 years (OR = 3.0; 95% CI = 2.2–4.1; P < 0.001) compared with children < 5 years, HIV-infected patients (OR = 2.4; 95% CI = 1.7–3.4; P < 0.001), and severe illness (OR = 5.4; 95% CI = 3.6–8.1; P < 0.001). On multivariate analysis, mortality was associated with patients aged ≥50 years [adjusted OR (AOR) = 3.6, 95% CI = 2.1–6.1, P < 0.001] and severe illness (AOR = 6.3; 95% CI = 3.8–10.5; P < 0.001).Mortality due to iNTS in Gauteng remains high primarily due to disease severity. Interventions must be aimed at predisposing conditions, including HIV, other immune-suppressive conditions, and malignancy.

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“…In Malawi, 4.6% of children with severe malaria had bacteremia, with NTS accounting for 58% of the cases (Bronzan et al, 2007). Park et al (2016) in their multicenter study in 13 sites across sub-Saharan Africa, found a positive correlation between invasive NTS disease and malaria endemicity. Furthermore, a study carried out in mice co-infected with malaria and Salmonella revealed that the host defense against malaria infection is accompanied by high susceptibility to NTS bacteremia (MacLennan, 2012).…”

Section: Risk Factors Of Salmonella Infectionmentioning

confidence: 99%

Untitled

2017

IRJPEH

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The impact of non-typhoidal Salmonella (NTS) infections on human and animal health, with the associated morbidity and mortality is a global issue of public health concern. The socioeconomic conditions in the developing countries particularly the sub-Saharan Africa seem to further aggravate the rate and seriousness of the infections. Thus the endemicity of NTS infections to sub-Saharan Africa as well as the resistance of the NTS strains to both antimicrobials and environmental stress is shown in this review. The association of Salmonella virulence plasmids with both antibiotic and stress resistance genes could play a major role in the persistence and spread of the resistance and virulence genes in Salmonella and other related pathogens. This may constitute a serious public health challenge in resource-limited rural African settings.

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The Relationship Between Invasive NontyphoidalSalmonellaDisease, Other Bacterial Bloodstream Infections, and Malaria in Sub-Saharan Africa

Cited by 66 publications

References 39 publications

Prevalence ofSalmonellaExcretion in Stool: A Community Survey in 2 Sites, Guinea-Bissau and Senegal

Prevalence ofSalmonellaExcretion in Stool: A Community Survey in 2 Sites, Guinea-Bissau and Senegal

Clinical and microbiological features of invasive nontyphoidal Salmonella associated with HIV-infected patients, Gauteng Province, South Africa

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