Inversive Salmonolosis in Sub - Saharan Africa

Tinashe Mashumba

Scientific advisor: prof. Koval G.M.

Uzhgorod National University

Uzhgorod, Ukraine

By Tinashe MashumbaMBBS -STUDENT

5TH YEAR

• GOAL 3 and 6

• Ensure healthy lives and promote well-being for all at all agesEnsure availability and sustainable management of water and sanitation for allGOAL 3

• Ensure healthy lives and promote well-being for all at all ages

Sustainable Development Goals 25 September 2015 - 2030

Epidemiology Africa

Salmonella enterica causing human disease are divided into human-restricted typhoidal serovars (Typhi and Paratyphi) causing typhoid fever, and non-typhoidal

Salmonella (NTS) serovars which have a broader host-range and are frequently zoonotic.

Non-Typhi Salmonella (NTS) is among the 3 most common pathogens causing bacterial bloodstream infections in adults and children in sub-Saharan Africa [2, 3]. Children <3 years old and human immunodeficiency virus (HIV)-

infected adults carry most of the burden of invasive disease, and mortality among these groups is high

Food and water. Seasonal peaks of NTS disease occur with the rainy season among both adults and children

Environmental Risk Factors in iNTS

Zoonotic transmission and transmission between humans. Animal contact, particularly handling of young chickens by children

Hospital-acquired infection. Outbreaks of NTS disease have been reported in hospitals in many parts of the Africa, occurring among patients who are admitted with a different diagnosis

Age. Children and infants <3 years old are particularly at risk for invasive NTS disease

Exposure to antimicrobial agents. Recent use of antimicrobial agents is an established risk factor for development of NTS diarrhea

Malaria and anemia. Malaria has long been suspected to increase the risk of invasive NTS infection and might contribute to the seasonality of NTS disease.

HIV infection. NTS bacteremia is more common among HIV-infected individuals

Host Risk Factors

Global Burden in Southern Africa

The burden of mortality due to childhood invasive bacterial disease may be greater than that due to childhood malaria in some African communities

The incidence of invasive NTS disease in sub-Saharan Africa is likely to be higher than the incidence of typhoid fever

A South African autopsy study of 50 patients who died and had a premortem clinical diagnosis of tuberculosis revealed that 94% were HIV infected and 23% of HIV-infected patients were harboring splenic NTS .

Conclusions and Future Directions

NTS Vaccine Prospects - immunological clues suggest that vaccine development directed toward the common invasive serotypes could be a useful approach to prevent invasive NTS disease.

A scale-up of access to blood culture or to improved alternative diagnostic methods is needed to support such studies, to improve patient care, and to inform policy

Clinical effectiveness studies and surveillance of antimicrobial resistance and serotype distribution are needed to inform clinical management strategies, to detect changes in patterns of disease, and to assist in vaccine development.

Despite the substantial burden of illness and death caused by invasive NTS disease, much remains to be done to understand and control invasive NTS disease in sub-Saharan Africa

References Brenner FW, Villar RG, Angulo FJ, Tauxe R, Swaminathan B. Salmonella nomenclature. J Clin Microbiol

Shaw AV, Reddy EA, Crump JA. Etiology of community-acquired bloodstream infections in Africa [abstract L-620]. In: Program and abstracts of the 46th Annual Meeting of the Infectious Diseases Society of America (Washington, DC). Alexandria, VA: Infectious Diseases Society of America; 2008.

Sigauque B, Roca A, Mandomando I, et al. Community-acquired bacteremia among children admitted to a rural hospital in Mozambique. Pediatr Infect Dis J 2009;28:108-13.

CrossRefMedlineWeb of ScienceGoogle Scholar Berkley JA, Lowe BS, Mwangi I, et al. Bacteremia among children admitted to a rural hospital in Kenya. N Engl J Med 2005;352:39-47.

CrossRefMedlineWeb of ScienceGoogle Scholar

thank you for your attention