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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. Leon, Clemens, John D., Reyburn, Hugh, Magesa, Stephen and Deen, Jacqueline L. (2010). Invasive salmonellosis among children admitted to a rural Tanzanian hospital and a comparison with previous studies. PLoS One,5(2):e9244.

Document type: Journal Article
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Title Invasive salmonellosis among children admitted to a rural Tanzanian hospital and a comparison with previous studies
Author Mtove, George
Amos, Ben
von Seidlein, Lorenz
Hendriksen, Ilse
Mwambuli, Abraham
Kimera, Juma
Mallahiyo, Rajabu
Kim, Deok Ryun
Ochiai, R. Leon
Clemens, John D.
Reyburn, Hugh
Magesa, Stephen
Deen, Jacqueline L.
Journal Name PLoS One
Publication Date 2010
Volume Number 5
Issue Number 2
ISSN 1932-6203   (check CDU catalogue open catalogue search in new window)
Start Page e9244
Total Pages 8
Place of Publication United States
Publisher Public Library of Science
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.
Keywords invasive salmonellosis
African children
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