Invasive non-Typhi Salmonella disease in Africa.
Invasive non-Typhi Salmonella is endemic to sub-Saharan Africa, where it is a leading cause of bloodstream infection. Some host risk factors have been established, but little is known about environmental reservoirs and predominant modes of transmission, so prevention strategies are underdeveloped. Although foodborne transmission from animals to humans predominates in high-income countries, it has been postulated that transmission between humans, both within and outside health care facilities, may be important in sub-Saharan Africa. Antimicrobial resistance to ampicillin, trimethoprim-sulfamethoxazole, and chloramphenicol is common among non-Typhi Salmonella strains; therefore, wider use of alternative agents may be warranted for empirical therapy. Development of vaccines targeting the leading invasive non-Typhi Salmonella serotypes Typhimurium and Enteritidis is warranted. The clinical presentation of non-Typhi Salmonella bacteremia is nonspecific and, in the absence of blood culture, may be confused with other febrile illnesses, such as malaria. Much work remains to be done to understand and control invasive non-Typhi Salmonella disease in sub-Saharan Africa.
Morpeth
Susan C
SC
Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
Ramadhani
Habib O
HO
Crump
John A
JA
D017954:Africa South of the Sahara / Q000453:epidemiology; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D006801:Humans; D012475:Salmonella / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification*; D012478:Salmonella Food Poisoning / Q000453:epidemiology / Q000382:microbiology; D012480:Salmonella Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000635:transmission; D012481:Salmonella Infections, Animal / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission
D000900:Anti-Bacterial Agents