Invasive non-typhoidal salmonella disease: an emerging and neglected tropical disease in Africa

Feasey, Nicholas A., Dougan, Gordon, Kingsley, Robert A., Heyderman, Robert and Gordon, Melita A. (2012) 'Invasive non-typhoidal salmonella disease: an emerging and neglected tropical disease in Africa'. Lancet, Vol 379, Issue 9835, pp. 2489-2499.

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Abstract

Invasive strains of non-typhoidal salmonellae have emerged as a prominent cause of bloodstream infection in African adults and children, with an associated case fatality of 20–25%. The clinical presentation of invasive non-typhoidal salmonella disease in Africa is diverse: fever, hepatosplenomegaly, and respiratory symptoms are common, and features of enterocolitis are often absent. The most important risk factors are HIV infection in adults, and malaria, HIV, and malnutrition in children. A distinct genotype of Salmonella enterica var Typhimurium, ST313, has emerged as a new pathogenic clade in sub-Saharan Africa, and might have adapted to cause invasive disease in human beings. Multidrug-resistant ST313 has caused epidemics in several African countries, and has driven the use of expensive antimicrobial drugs in the poorest health services in the world. Studies of systemic cellular and humoral immune responses in adults infected with HIV have revealed key host immune defects contributing to invasive non-typhoidal salmonella disease. This emerging pathogen might therefore have adapted to occupy an ecological and immunological niche provided by HIV, malaria, and malnutrition in Africa. A good understanding of the epidemiology of this neglected disease will open new avenues for development and implementation of vaccine and public health strategies to prevent infections and interrupt transmission.

Item Type:	Article
Subjects:	WA Public Health > WA 105 Epidemiology WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WC Communicable Diseases > Infection. Bacterial Infections > Enteric Infections > WC 269 Salmonella infections
Digital Object Identifer (DOI):	https://doi.org/10.1016/s0140-6736(11)61752-2
Depositing User:	Lynn Roberts-Maloney
Date Deposited:	07 Jan 2015 15:06
Last Modified:	18 May 2018 14:15
URI:	https://archive.lstmed.ac.uk/id/eprint/4713

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