Nontyphoidal Salmonella among Children under 5 Years Old in Sub-Saharan Africa and South Asia in the Global Enteric Multicenter Study

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  • 1 Nutrition and Clinical Services Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh

Factors associated with nontyphoidal Salmonella (NTS) infection have not been well characterized to date. We aimed to compare the associated factors among children under age 5 years with NTS infection in sub-Saharan Africa and South Asia. Data from children having moderate-to-severe diarrhea (MSD) and asymptomatic children with NTS isolated from fecal specimens were extracted from the Global Enteric Multicenter Study (GEMS), conducted from December 2007 to March 2011. Compared with NTS-negative children, NTS-associated MSD cases in South Asia were associated with the presence of goat in the house (adjusted odds ratio [aOR]: 2.15; 95% confidence interval [CI]: 1.25–3.70) and handwashing after handling an animal (aOR: 2.26; 95% CI: 1.36–3.74). In sub-Saharan Africa, children with NTS associated MSD had a greater association with stunting (1.21 95% CI: 1.01–1.45), longer duration of diarrhea (aOR: 1.25 95% CI: 1.19–1.31); presence of cow in house (aOR: 1.54 95% CI: 1.09–2.16), handwashing after handling animal (aOR: 2.41 95% CI: 1.74–3.33). Drinking tube well water (aOR: 0.54 95% CI: 0.32–0.91), availability of toilet facility (aOR: 0.58 95% CI: 0.53–0.65), and handwashing before eating (aOR: 0.76 95% CI: 0.57–1.00) and after defecation (aOR: 0.80 95% CI: 0.69, 0.94) were found to be protective. The differentials between children of both regions having fecal NTS are distinct and underscore the need for policymaking for preventive and control strategies targeting stunted children.

Author Notes

Address correspondence to Abu Syed Golam Faruque, Nutrition and Clinical Services Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka-1212, Bangladesh. E-mail: gfaruque@icddrb.org

Financial support: This work was supported, in whole or in part, by the Bill & Melinda Gates Foundation (grant no. INV-002050). Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission.

Authors’ addresses: Rina Das, Md Ahshanul Haque, Mohammod Jobayer Chisti, Tahmeed Ahmed, and Abu Syed Golam Faruque, Nutrition and Clinical Services Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. Emails: rina.das@icddrb.org, ahshanul.haque@icddrb.org, chisti@icddrb.org, tahmeed@icddrb.org, and gfaruque@icddrb.org.

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