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The burden of invasive bacterial infections in Pemba Zanibar

Thriemer, Kamala, Ley, Benedikt, Ame, Shaali M., von Seidlein, Lorenz, Deok, Pak Gi, Chang, Na Yoon, Hashim, R., Schmied, Wolfgang, Busch, Clara, Nixon, Shanette, Morrissey, Anne, Puri, Mahesh K., Ali, Mohammad, Ochiai, R., Wierzba, Thomas, Jiddawi, Mohamed Saleh, Clemens, John D., Ali, Said Mohammed and Deen, Jacqueline L. (2012). The burden of invasive bacterial infections in Pemba Zanibar. PLoS One,7(2):e30350.

Document type: Journal Article
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Title The burden of invasive bacterial infections in Pemba Zanibar
Author Thriemer, Kamala
Ley, Benedikt
Ame, Shaali M.
von Seidlein, Lorenz
Deok, Pak Gi
Chang, Na Yoon
Hashim, R.
Schmied, Wolfgang
Busch, Clara
Nixon, Shanette
Morrissey, Anne
Puri, Mahesh K.
Ali, Mohammad
Ochiai, R.
Wierzba, Thomas
Jiddawi, Mohamed Saleh
Clemens, John D.
Ali, Said Mohammed
Deen, Jacqueline L.
Journal Name PLoS One
Publication Date 2012
Volume Number 7
Issue Number 2
ISSN 1932-6203   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84857203660
Start Page e30350
Total Pages 9
Place of Publication United States
Publisher Public Library of Science
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
We conducted a surveillance study to determine the leading causes of bloodstream infection in febrile patients seeking treatment at three district hospitals in Pemba Island, Zanzibar, Tanzania, an area with low malaria transmission.

All patients above two months of age presenting to hospital with fever were screened, and blood was collected for microbiologic culture and malaria testing. Bacterial sepsis and malaria crude incidence rates were calculated for a one-year period and were adjusted for study participation and diagnostic sensitivity of blood culture.

Blood culture was performed on 2,209 patients. Among them, 166 (8%) samples yielded bacterial growth; 87 (4%) were considered as likely contaminants; and 79 (4%) as pathogenic bacteria. The most frequent pathogenic bacteria isolated were Salmonella Typhi (n = 46; 58%), followed by Streptococcus pneumoniae (n = 12; 15%). The crude bacteremia rate was 6/100,000 but when adjusted for potentially missed cases the rate may be as high as 163/100,000. Crude and adjusted rates for S. Typhi infections and malaria were 4 and 110/100,000 and 4 and 47/100,000, respectively. Twenty three (51%), 22 (49%) and 22 (49%) of the S.Typhi isolates were found to be resistant toward ampicillin, chloramphenicol and cotrimoxazole, respectively. Multidrug resistance (MDR) against the three antimicrobials was detected in 42% of the isolates.

In the presence of very low malaria incidence we found high rates of S. Typhi and S. pneumoniae infections on Pemba Island, Zanzibar. Preventive measures such as vaccination could reduce the febrile disease burden.
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