Invasive Salmonellosis among Children Admitted to a Rural Tanzanian Hospital and a Comparison with Previous Studies

George Mtove, Ben Amos, Lorenz Von Seidlein, Ilse Hendriksen, Abraham Mwambuli, Juma Kimera, Rajabu Mallahiyo, Deok Ryun Kim, R Ochiai, John D Clemens, Hugh Reyburn, Stephen Magesa, Jaqueline Deen

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: The importance of invasive salmonellosis in African children is well recognized but there is inadequate information on these infections. We conducted a fever surveillance study in a Tanzanian rural hospital to estimate the case fraction of invasive salmonellosis among pediatric admissions, examine associations with common co-morbidities and describe its clinical features. We compared our main findings with those from previous studies among children in sub-Saharan Africa.

    Methodology/Principal Findings: From 1 March 2008 to 28 Feb 2009, 1,502 children were enrolled into the study. We collected clinical information and blood for point of care tests, culture, and diagnosis of malaria and HIV. We analyzed the clinical features on admission and outcome by laboratory-confirmed diagnosis. Pathogenic bacteria were isolated from the blood of 156 (10%) children, of which 14 (9%) were S. typhi, 45 (29%) were NTS and 97 (62%) were other pathogenic bacteria. Invasive salmonellosis accounted for 59/156 (38%) bacteremic children. Children with typhoid fever were significantly older and presented with a longer duration of fever. NTS infections were significantly associated with prior antimalarial treatment, malarial complications and with a high risk for death.

    Conclusions/Significance:
    Invasive salmonellosis, particularly NTS infection, is an important cause of febrile disease among hospitalized children in our rural Tanzanian setting. Previous studies showed considerable variation in the case fraction of S.
    typhi and NTS infections. Certain suggestive clinical features (such as older age and long duration of fever for typhoid whereas concomitant malaria, anemia, jaundice and hypoglycemia for NTS infection) may be used to distinguish invasive salmonellosis from other severe febrile illness.
    Original languageEnglish
    Article numbere9244
    Pages (from-to)1-8
    Number of pages8
    JournalPLoS One
    Volume5
    Issue number2
    DOIs
    Publication statusPublished - 16 Feb 2010

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    rural hospitals
    Rural Hospitals
    Salmonella Infections
    salmonellosis
    Bacteria
    Blood
    Pediatrics
    Antimalarials
    Fever
    fever
    Infection
    typhoid fever
    Typhoid Fever
    infection
    Malaria
    malaria
    Point-of-Care Systems
    Hospitalized Child
    Africa South of the Sahara
    Clinical Laboratory Techniques

    Cite this

    Mtove, G., Amos, B., Von Seidlein, L., Hendriksen, I., Mwambuli, A., Kimera, J., ... Deen, J. (2010). Invasive Salmonellosis among Children Admitted to a Rural Tanzanian Hospital and a Comparison with Previous Studies. PLoS One, 5(2), 1-8. [e9244 ]. https://doi.org/10.1371/journal.pone.0009244
    Mtove, George ; Amos, Ben ; Von Seidlein, Lorenz ; Hendriksen, Ilse ; Mwambuli, Abraham ; Kimera, Juma ; Mallahiyo, Rajabu ; Kim, Deok Ryun ; Ochiai, R ; Clemens, John D ; Reyburn, Hugh ; Magesa, Stephen ; Deen, Jaqueline. / Invasive Salmonellosis among Children Admitted to a Rural Tanzanian Hospital and a Comparison with Previous Studies. In: PLoS One. 2010 ; Vol. 5, No. 2. pp. 1-8.
    @article{a9229fdd09604ac0900032c197ed547c,
    title = "Invasive Salmonellosis among Children Admitted to a Rural Tanzanian Hospital and a Comparison with Previous Studies",
    abstract = "Background: The importance of invasive salmonellosis in African children is well recognized but there is inadequate information on these infections. We conducted a fever surveillance study in a Tanzanian rural hospital to estimate the case fraction of invasive salmonellosis among pediatric admissions, examine associations with common co-morbidities and describe its clinical features. We compared our main findings with those from previous studies among children in sub-Saharan Africa.Methodology/Principal Findings: From 1 March 2008 to 28 Feb 2009, 1,502 children were enrolled into the study. We collected clinical information and blood for point of care tests, culture, and diagnosis of malaria and HIV. We analyzed the clinical features on admission and outcome by laboratory-confirmed diagnosis. Pathogenic bacteria were isolated from the blood of 156 (10{\%}) children, of which 14 (9{\%}) were S. typhi, 45 (29{\%}) were NTS and 97 (62{\%}) were other pathogenic bacteria. Invasive salmonellosis accounted for 59/156 (38{\%}) bacteremic children. Children with typhoid fever were significantly older and presented with a longer duration of fever. NTS infections were significantly associated with prior antimalarial treatment, malarial complications and with a high risk for death.Conclusions/Significance: Invasive salmonellosis, particularly NTS infection, is an important cause of febrile disease among hospitalized children in our rural Tanzanian setting. Previous studies showed considerable variation in the case fraction of S.typhi and NTS infections. Certain suggestive clinical features (such as older age and long duration of fever for typhoid whereas concomitant malaria, anemia, jaundice and hypoglycemia for NTS infection) may be used to distinguish invasive salmonellosis from other severe febrile illness.",
    author = "George Mtove and Ben Amos and {Von Seidlein}, Lorenz and Ilse Hendriksen and Abraham Mwambuli and Juma Kimera and Rajabu Mallahiyo and Kim, {Deok Ryun} and R Ochiai and Clemens, {John D} and Hugh Reyburn and Stephen Magesa and Jaqueline Deen",
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    Mtove, G, Amos, B, Von Seidlein, L, Hendriksen, I, Mwambuli, A, Kimera, J, Mallahiyo, R, Kim, DR, Ochiai, R, Clemens, JD, Reyburn, H, Magesa, S & Deen, J 2010, 'Invasive Salmonellosis among Children Admitted to a Rural Tanzanian Hospital and a Comparison with Previous Studies', PLoS One, vol. 5, no. 2, e9244 , pp. 1-8. https://doi.org/10.1371/journal.pone.0009244

    Invasive Salmonellosis among Children Admitted to a Rural Tanzanian Hospital and a Comparison with Previous Studies. / Mtove, George; Amos, Ben; Von Seidlein, Lorenz; Hendriksen, Ilse; Mwambuli, Abraham; Kimera, Juma; Mallahiyo, Rajabu; Kim, Deok Ryun; Ochiai, R; Clemens, John D; Reyburn, Hugh; Magesa, Stephen; Deen, Jaqueline.

    In: PLoS One, Vol. 5, No. 2, e9244 , 16.02.2010, p. 1-8.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Invasive Salmonellosis among Children Admitted to a Rural Tanzanian Hospital and a Comparison with Previous Studies

    AU - Mtove, George

    AU - Amos, Ben

    AU - Von Seidlein, Lorenz

    AU - Hendriksen, Ilse

    AU - Mwambuli, Abraham

    AU - Kimera, Juma

    AU - Mallahiyo, Rajabu

    AU - Kim, Deok Ryun

    AU - Ochiai, R

    AU - Clemens, John D

    AU - Reyburn, Hugh

    AU - Magesa, Stephen

    AU - Deen, Jaqueline

    PY - 2010/2/16

    Y1 - 2010/2/16

    N2 - Background: The importance of invasive salmonellosis in African children is well recognized but there is inadequate information on these infections. We conducted a fever surveillance study in a Tanzanian rural hospital to estimate the case fraction of invasive salmonellosis among pediatric admissions, examine associations with common co-morbidities and describe its clinical features. We compared our main findings with those from previous studies among children in sub-Saharan Africa.Methodology/Principal Findings: From 1 March 2008 to 28 Feb 2009, 1,502 children were enrolled into the study. We collected clinical information and blood for point of care tests, culture, and diagnosis of malaria and HIV. We analyzed the clinical features on admission and outcome by laboratory-confirmed diagnosis. Pathogenic bacteria were isolated from the blood of 156 (10%) children, of which 14 (9%) were S. typhi, 45 (29%) were NTS and 97 (62%) were other pathogenic bacteria. Invasive salmonellosis accounted for 59/156 (38%) bacteremic children. Children with typhoid fever were significantly older and presented with a longer duration of fever. NTS infections were significantly associated with prior antimalarial treatment, malarial complications and with a high risk for death.Conclusions/Significance: Invasive salmonellosis, particularly NTS infection, is an important cause of febrile disease among hospitalized children in our rural Tanzanian setting. Previous studies showed considerable variation in the case fraction of S.typhi and NTS infections. Certain suggestive clinical features (such as older age and long duration of fever for typhoid whereas concomitant malaria, anemia, jaundice and hypoglycemia for NTS infection) may be used to distinguish invasive salmonellosis from other severe febrile illness.

    AB - Background: The importance of invasive salmonellosis in African children is well recognized but there is inadequate information on these infections. We conducted a fever surveillance study in a Tanzanian rural hospital to estimate the case fraction of invasive salmonellosis among pediatric admissions, examine associations with common co-morbidities and describe its clinical features. We compared our main findings with those from previous studies among children in sub-Saharan Africa.Methodology/Principal Findings: From 1 March 2008 to 28 Feb 2009, 1,502 children were enrolled into the study. We collected clinical information and blood for point of care tests, culture, and diagnosis of malaria and HIV. We analyzed the clinical features on admission and outcome by laboratory-confirmed diagnosis. Pathogenic bacteria were isolated from the blood of 156 (10%) children, of which 14 (9%) were S. typhi, 45 (29%) were NTS and 97 (62%) were other pathogenic bacteria. Invasive salmonellosis accounted for 59/156 (38%) bacteremic children. Children with typhoid fever were significantly older and presented with a longer duration of fever. NTS infections were significantly associated with prior antimalarial treatment, malarial complications and with a high risk for death.Conclusions/Significance: Invasive salmonellosis, particularly NTS infection, is an important cause of febrile disease among hospitalized children in our rural Tanzanian setting. Previous studies showed considerable variation in the case fraction of S.typhi and NTS infections. Certain suggestive clinical features (such as older age and long duration of fever for typhoid whereas concomitant malaria, anemia, jaundice and hypoglycemia for NTS infection) may be used to distinguish invasive salmonellosis from other severe febrile illness.

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    JO - PLoS One

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