Non-typhoidal salmonellae: a management challenge for children with community-acquired invasive disease in tropical African countries.

摘要

Although a single species, more than 2000 serovars of Salmonella enterica have been identified, including Typhi, Typhimurium, and Enteritidis. S enterica var Typhi (or S typhi) causes invasive disease, which is particularly common in Asia, whereas non-typhoidal salmonellae are important causes of food-borne infections and cause mainly gastroenteritis in developed countries. Far less recognised is the disease burden in tropical African countries. Non-typhoidal salmonellae (mainly S typhimurium and S enteritidis) have long been a common cause of invasive disease in children, especially during rainy seasons, consistently associated with young age (most cases present between 6 months and 3 years of age), anaemia, malnutrition, and of late with HIV infection. Reported case-fatality rate for non-typhoidal salmonellae bacteraemia is more than 20%. Non-typhoidal salmonellae are also a common and frequently fatal cause of meningitis. Reports of the disease burden from the region include sick children who present to rural district facilities and to urban hospitals.