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Typhoid Fever and Invasive Nontyphoid

By Nicholas A. Feasey, Brett N. Archer, Robert S. Heyderman, Arvinda Sooka, Brigitte Dennis, Melita A. Gordon and Karen H. Keddy

Abstract

To determine the prevalence of invasive nontyphoid salmonellosis and typhoid fever in Malawi and South Africa, we compared case frequency and patient age distribution. Invasive nontyphoid salmonellosis showed a clear bimodal age distribution; the infection developed in women at a younger age than in men. Case frequency for typhoid fever was lower than for salmonellosis. Invasive nontyphoid salmonellosis (iNTS) was first described as an AIDS-related illness in Africa and the United States in the 1980s. Although incidence in industrialized countries declined, nontyphoid Salmonella (NTS) spp. serovars (predominantly S. enterica serovars Typhimurium and Enteritidis) remain a common cause of bloodstream and focal infection in sub-Saharan Africa for adults with HIV infection and children with HIV, malaria, and malnutrition. iNTS has a strong seasonal pattern in adults and children. In addition, epidemics of iNTS have been described as associated with the emergence of multidrug resistance in Malawi (1). Similarly, multidrug resistance is well recognized in iNTS in South Africa (www.nicd.ac.za/pubs/survbull/2010/CommDisBullMay10_Vol0802.pdf). Death rates are 20%– 25 % among adults and children (1). In sub-Saharan Africa, transmission is thought most likely to Page 1 of 7be between humans, and no food or animal source has been found, although epidemiologic dat

Year: 2010
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