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Thindwa, Deus, Chipeta, Michael G, Henrion, Marc and Gordon, Melita (2019) 'Distinct climate influences on the risk of typhoid compared to invasive non-typhoid Salmonella disease in Blantyre, Malawi.'. Scientific reports, Vol 9, Issue 1, p. 20310.
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294064_1_merged_1574096428 - M Henrion.pdf - Accepted Version Available under License Creative Commons Attribution. Download (4MB) | Preview |
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Nature - M Henrion Jan 2020.pdf - Published Version Available under License Creative Commons Attribution. Download (2MB) | Preview |
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294064_1_supp_8382367_q16c37_convrt - M Henrion.pdf - Accepted Version Available under License Creative Commons Attribution. Download (9MB) | Preview |
Abstract
Invasive Salmonella diseases, both typhoid and invasive non-typhoidal Salmonella (iNTS), are seasonal bloodstream infections causing important morbidity and mortality globally in Africa. The reservoirs and transmission of both are not fully understood. We hypothesised that differences in the time-lagged relationships of rainfall or temperature with typhoid and iNTS incidence might infer differences in epidemiology. We assessed the dynamics of invasive Salmonella incidence over a 16-year period of surveillance, quantifying incidence peaks, seasonal variations, and nonlinear effects of rainfall and temperature exposures on the relative risks of typhoid and iNTS, using monthly lags. An increased relative risk of iNTS incidence was short-lasting but immediate after the onset of the rains, whereas that of typhoid was long-lasting but with a two months delayed start, implying a possible difference in transmission. The relative-risk function of temperature for typhoid was bimodal, with higher risk at both lower (with a 1 month lag) and higher (with a ≥4 months lag) temperatures, possibly reflecting the known patterns of short and long cycle typhoid transmission. In contrast, the relative-risk of iNTS was only increased at lower temperatures, suggesting distinct transmission mechanisms. Environmental and sanitation control strategies may be different for iNTS compared to typhoid disease.
| Item Type: | Article |
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| Subjects: | 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 WC Communicable Diseases > Infection. Bacterial Infections > Enteric Infections > WC 270 Typhoid fever |
| Faculty: Department: | Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW) |
| Digital Object Identifer (DOI): | https://doi.org/10.1038/s41598-019-56688-1 |
| Depositing User: | Julie Franco |
| Date Deposited: | 14 Jan 2020 15:59 |
| Last Modified: | 14 Jan 2020 15:59 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/13519 |
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