| Title: |
The relationship between invasive nontyphoidal salmonella disease, other bacterial bloodstream infections, and malaria in Sub-Saharan Africa |
| Authors: |
Park, SE; Pak, GD; Aaby, P; Adu-Sarkodie, Y; Ali, M; Aseffa, A; Biggs, HM; Bjerregaard-Andersen, M; Breiman, RF; Crump, JA; Cruz Espinoza, LM; Eltayeb, MA; Gasmelseed, N; Hertz, JT; Im, J; Jaeger, A; Kabore, LP; von Kalckreuth, V; Keddy, KH; Konings, F; Krumkamp, R; MacLennan, CA; Meyer, CG; Montgomery, JM; Niang, AA; Nichols, C; Olack, B; Panzner, U; Park, JK; Rabezanahary, H; Rakotozandrindrainy, R; Sampo, E; Sarpong, N; Schütt-Gerowitt, H; Sooka, A; Soura, AB; Sow, AG; Tall, A; Teferi, M; Yeshitela, B; May, J; Wierzba, TF; Clemens, JD; Baker, S; Marks, F |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2016 |
| Collection: |
Oxford University Research Archive (ORA) |
| Description: |
Background. Country-specific studies in Africa have indicated that Plasmodium falciparum is associated with invasive nontyphoidal Salmonella (iNTS) disease. We conducted a multicenter study in 13 sites in Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania to investigate the relationship between the occurrence of iNTS disease, other systemic bacterial infections, and malaria. Methods. Febrile patients received a blood culture and a malaria test. Isolated bacteria underwent antimicrobial susceptibility testing, and the association between iNTS disease and malaria was assessed. Results. A positive correlation between frequency proportions of malaria and iNTS was observed (P = .01; r = 0.70). Areas with higher burden of malaria exhibited higher odds of iNTS disease compared to other bacterial infections (odds ratio [OR], 4.89; 95% CI, 1.61–14.90; P = .005) than areas with lower malaria burden. Malaria parasite positivity was associated with iNTS disease (OR, 2.44; P = .031) and gram-positive bacteremias, particularly Staphylococcus aureus , exhibited a high proportion of coinfection with Plasmodium malaria. Salmonella Typhimurium and Salmonella Enteritidis were the predominant NTS serovars (53/73; 73%). Both moderate (OR, 6.05; P = .0001) and severe (OR, 14.62; P < .0001) anemia were associated with iNTS disease. Conclusions. A positive correlation between iNTS disease and malaria endemicity, and the association between Plasmodium parasite positivity and iNTS disease across sub-Saharan Africa, indicates the necessity to consider iNTS as a major cause of febrile illness in malaria-holoendemic areas. Prevention of iNTS disease through iNTS vaccines for areas of high malaria endemicity, targeting high-risk groups for Plasmodium parasitic infection, should be considered. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://doi.org/10.1093/cid/civ893 |
| DOI: |
10.1093/cid/civ893 |
| Availability: |
https://doi.org/10.1093/cid/civ893; https://ora.ox.ac.uk/objects/uuid:e8f9ed49-21f1-452c-8a60-5ad67dc750f3 |
| Rights: |
info:eu-repo/semantics/embargoedAccess |
| Accession Number: |
edsbas.BB1D3FA4 |
| Database: |
BASE |