Prevalence and Correlates of NTS Bacteremia, Diarrhea and Carriage in Kenya

肯尼亚 NTS 菌血症、腹泻和带菌的患病率及相关性

• 批准号: 8707323
• 负责人: Judd L. Walson
• 金额: $ 29.91万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8707323
• 关键词: 5 year old; Address; Africa; Africa South of the Sahara; African; Age; Area; Bacteremia; Blood; Cause of Death; Characteristics; Child; Childhood; Clinical; Complex; Control Groups; Crowding; Data; Developed Countries; Development; Diarrhea; Disease; Drug resistance; Economic Conditions; Environment; Environmental Risk Factor; Epidemiology; Exposure to; Family; Fever; Genetic Variation; HIV; HIV Infections; Helminths; Hemolysis; High Prevalence; Host Defense Mechanism; Human; Immune; Immunosuppression; Incidence; Individual; Infection; Instruction; Integration Host Factors; Iron; Kenya; Lead; Livestock; Logistic Regressions; Low Prevalence; Malaria; Malnutrition; Modeling; Molecular; Nutritional status; Outcome; Patients; Pneumococcal Infections; Pneumonia; Predisposition; Prevalence; Pulsed-Field Gel Electrophoresis; Relative (related person); Research Infrastructure; Risk; Role; Route; Rural; Salmonella; Sanitation; Sepsis; Severity of illness; Site; Viral; Virulence; Virulence Factors; Water; base; clinical research site; cofactor; cohort; comparison group; design; foodborne; indexing; pathogen; pressure; prevent; socioeconomics; transmission process

SUMMARY (See instructions); Invasive infections due to non-typhoidal salmonella strains (NTS) appear to be emerging as a common cause of bloodstream infection in sub-Saharan Africa. As many as 40% of blood culture isolates from bacteremic children and 20% of blood culture isolates in children with severe pneumonia are due to NTS in Africa. While the exact reasons for the high burden and severity of disease due to invasive NTS are incompletely understood, it appears that transmission of NTS may be largely due to human-human contact in Africa. This is in contrast to the largely foodborne route of transmission seen in other areas of the world Differences in host characteristics (high rates of HIV, malnutrition) and differing socio-economic conditions (poor access to clean water and sanitation, more rural environment) may contribute to human-human risk of transmission. In addition, it is possible that pathogen specific differences may also be important in increasing the diversity and virulence of NTS isolates in Africa. We propose to more clearly define the epidemiology of NTS disease in Africa by examining differences in host susceptibility, changes in strain diversity and virulence, and the role of asymptomafic carriage in promofing human-human transmission of NTS.

摘要（参见说明）； 由非伤寒沙门氏菌菌株 (NTS) 引起的侵袭性感染似乎正在成为一种新的疾病 撒哈拉以南非洲地区血流感染的常见原因。在非洲，菌血症儿童中多达 40% 的血培养分离物和重症肺炎儿童中 20% 的血培养分离物是由 NTS 引起的。虽然侵入性 NTS 造成的高负担和严重疾病的确切原因尚不完全清楚，但 NTS 的传播似乎主要是由于非洲的人与人接触。这与世界其他地区的主要食源性传播途径形成鲜明对比。宿主特征的差异（艾滋病毒感染率高、营养不良）和不同的社会经济条件（难以获得清洁水和卫生设施、更多的农村环境）可能会导致病毒传播。造成人与人之间传播的风险。此外，病原体特异性差异对于增加非洲 NTS 分离株的多样性和毒力也可能很重要。我们建议通过检查宿主易感性的差异、菌株多样性和毒力的变化以及无症状携带在促进 NTS 人际传播中的作用，更清楚地定义非洲 NTS 疾病的流行病学。