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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Salmonella bacteremia in Kenyan children
Pediatric Infectious Disease Journal, Volume 25, No. 3, Year 2006
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Description
Background: Nontyphoidal Salmonella spp. are among the leading causes of childhood bacteremia in sub-Saharan Africa, yet there are few published clinical series, and the risk factors for acquiring infection are not fully understood. Methods: We examined data from 166 cases of nontyphoidal Salmonella bacteremia identified during a large prospective study of bacteremia among all children admitted to a district hospital in Kenya. We also investigated the importance of comorbidities, including current malaria parasitemia, recent malaria (detectable Plasmodium falciparum histidine rich protein 2 in the absence of parasitemia), sickle cell disease, malnutrition and human immunodeficiency virus (HIV) infection. Results: Nontyphoidal Salmonella bacteremia was associated with severe malnutrition (33% cases), HIV infection (18% cases), a history of illness >7 days, recent hospital admission, splenomegaly, anemia and recent (but not current) malaria but was not associated with diarrhea. Seventy-seven (46%) children with nontyphoidal Salmonella bacteremia fulfilled World Health Organization clinical criteria for a diagnosis of pneumonia. Independent risk factors for death were diarrhea, tachypnea, HIV infection, severe malnutrition, meningitis and young age. Conclusions: Clinical diagnosis of invasive nontyphoidal Salmonella infection in African children is difficult without microbiology facilities because clinical features overlap with other conditions. The common risk factors for nontyphoidal Salmonella infection differ from developed countries, with high a prevalence of malnutrition, HIV, malaria and anemia. Children with nontyphoidal Salmonella infection who fulfill World Health Organization clinical criteria for severe pneumonia may receive ineffective therapy in the form of penicillin. Copyright © 2006 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Brent, Andrew J.
Kenya, Kilifi
Centre for Geographic Medicine Research
United Kingdom, Oxford
John Radcliffe Hospital
United Kingdom, Oxford
Chartwell House
Oundo, Joseph Wang Ang’a A.
Kenya, Kilifi
Centre for Geographic Medicine Research
Mwangi, Isaiah
Kenya, Kilifi
Centre for Geographic Medicine Research
Ochola, Lucy B.
Kenya, Kilifi
Centre for Geographic Medicine Research
Lowe, Brett S.
Kenya, Kilifi
Centre for Geographic Medicine Research
Berkley, James A.
Kenya, Kilifi
Centre for Geographic Medicine Research
United Kingdom, Oxford
John Radcliffe Hospital
Statistics
Citations: 211
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.1097/01.inf.0000202066.02212.ff
ISSN:
08913668
Research Areas
Food Security
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Kenya