The Relationship Between Invasive Nontyphoidal Salmonella Disease, Other Bacterial Bloodstream Infections, and Malaria in Sub-Saharan Africa.

Park, Se Eun

Pak, Gi Deok

Aaby, Peter

Adu-Sarkodie, Yaw

Ali, Mohammad

Aseffa, Abraham

Biggs, Holly M

Bjerregaard-Andersen, Morten

Breiman, Robert F

Crump, John A

Cruz Espinoza, Ligia Maria

Eltayeb, Muna Ahmed

Gasmelseed, Nagla

Hertz, Julian T

Im, Justin

Jaeger, Anna

Parfait Kabore, Leon

von Kalckreuth, Vera

Keddy, Karen H

Konings, Frank

Krumkamp, Ralf

MacLennan, Calman A

Meyer, Christian G

Montgomery, Joel M

Ahmet Niang, Aissatou

Nichols, Chelsea

Olack, Beatrice

Panzner, Ursula

Park, Jin Kyung

Rabezanahary, Henintsoa

Rakotozandrindrainy, Raphaël

Sampo, Emmanuel

Sarpong, Nimako

Schütt-Gerowitt, Heidi

Sooka, Arvinda

Soura, Abdramane Bassiahi

Sow, Amy Gassama

Tall, Adama

Teferi, Mekonnen

Yeshitela, Biruk

May, Jürgen

Wierzba, Thomas F

Clemens, John D

Baker, Stephen

Marks, Florian

United States

2017-03-02T18:56:44Z

2017-03-02T18:56:44Z

2016-03-15

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.

https://www.ncbi.nlm.nih.gov/pubmed/26933016

civ893

1537-6591

https://hdl.handle.net/10161/13760

eng

Oxford University Press (OUP)

Clin Infect Dis

10.1093/cid/civ893

NTS

Plasmodium

Salmonella

invasive NTS

malaria

Adolescent

Adult

Africa South of the Sahara

Analysis of Variance

Child

Child, Preschool

Coinfection

Female

Humans

Infant

Infant, Newborn

Malaria

Male

Salmonella Infections

Salmonella enterica

Young Adult

The Relationship Between Invasive Nontyphoidal Salmonella Disease, Other Bacterial Bloodstream Infections, and Malaria in Sub-Saharan Africa.

Journal article

Hertz, Julian T|0000-0002-7396-4789

https://www.ncbi.nlm.nih.gov/pubmed/26933016

S23

S31

Clinical Science Departments

Duke

Medicine

Medicine, Infectious Diseases

Pathology

School of Medicine

Surgery

Surgery, Emergency Medicine

Published

62 Suppl 1