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Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural-Urban Transition Zone

BACKGROUND: Systemic bacterial infections are a major cause of paediatric febrile illness in sub-Saharan Africa. Aim of this study was to assess the effects of social and geographical determinants on the risk of bacteraemia in a rural-urban transition zone in Ghana. METHODS: Children below 15 years...

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Autores principales: Sothmann, Peter, Krumkamp, Ralf, Kreuels, Benno, Sarpong, Nimako, Frank, Clemens, Ehlkes, Lutz, Fobil, Julius, Gyau, Kennedy, Jaeger, Anna, Bosu, Benedicta, Marks, Florian, Owusu-Dabo, Ellis, Salzberger, Bernd, May, Jürgen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4587855/
https://www.ncbi.nlm.nih.gov/pubmed/26418004
http://dx.doi.org/10.1371/journal.pone.0139433
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author Sothmann, Peter
Krumkamp, Ralf
Kreuels, Benno
Sarpong, Nimako
Frank, Clemens
Ehlkes, Lutz
Fobil, Julius
Gyau, Kennedy
Jaeger, Anna
Bosu, Benedicta
Marks, Florian
Owusu-Dabo, Ellis
Salzberger, Bernd
May, Jürgen
author_facet Sothmann, Peter
Krumkamp, Ralf
Kreuels, Benno
Sarpong, Nimako
Frank, Clemens
Ehlkes, Lutz
Fobil, Julius
Gyau, Kennedy
Jaeger, Anna
Bosu, Benedicta
Marks, Florian
Owusu-Dabo, Ellis
Salzberger, Bernd
May, Jürgen
author_sort Sothmann, Peter
collection PubMed
description BACKGROUND: Systemic bacterial infections are a major cause of paediatric febrile illness in sub-Saharan Africa. Aim of this study was to assess the effects of social and geographical determinants on the risk of bacteraemia in a rural-urban transition zone in Ghana. METHODS: Children below 15 years of age with fever were recruited at an outpatient department in the suburban belt of Kumasi, Ghana’s second largest city. Blood was taken for bacterial culture and malaria diagnostics. The socio-economic status of participants was calculated using Principle Component Analysis. A scale, based on key urban characteristics, was established to quantify urbanicity for all communities in the hospital catchment area. A case-control analysis was conducted, where children with and without bacteraemia were cases and controls, respectively. RESULTS: Bacteraemia was detected in 72 (3.1%) of 2,306 hospital visits. Non-typhoidal Salmonella (NTS; n = 24; 33.3%) and Salmonella typhi (n = 18; 25.0%) were the most common isolates. Logistic regression analysis showed that bacteraemia was negatively associated with urbanicity (odds ratio [OR] = 0.8; 95% confidence interval [CI]: 0.7–1.0) and socio-economic status (OR = 0.8; 95% CI: 0.6–0.9). Both associations were stronger if only NTS infections were used as cases (OR = 0.5; 95% CI: 0.3–0.8 and OR = 0.6; 95% CI: 0.4–1.0, respectively). CONCLUSIONS: The results of this study highlight the importance of individual as well as community factors as independent risk factors for invasive bacterial infection (IBI) and especially NTS. Epidemiological data support physicians, public health experts and policy makers to identify disease prevention and treatment needs in order to secure public health in the transitional societies of developing countries.
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spelling pubmed-45878552015-10-02 Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural-Urban Transition Zone Sothmann, Peter Krumkamp, Ralf Kreuels, Benno Sarpong, Nimako Frank, Clemens Ehlkes, Lutz Fobil, Julius Gyau, Kennedy Jaeger, Anna Bosu, Benedicta Marks, Florian Owusu-Dabo, Ellis Salzberger, Bernd May, Jürgen PLoS One Research Article BACKGROUND: Systemic bacterial infections are a major cause of paediatric febrile illness in sub-Saharan Africa. Aim of this study was to assess the effects of social and geographical determinants on the risk of bacteraemia in a rural-urban transition zone in Ghana. METHODS: Children below 15 years of age with fever were recruited at an outpatient department in the suburban belt of Kumasi, Ghana’s second largest city. Blood was taken for bacterial culture and malaria diagnostics. The socio-economic status of participants was calculated using Principle Component Analysis. A scale, based on key urban characteristics, was established to quantify urbanicity for all communities in the hospital catchment area. A case-control analysis was conducted, where children with and without bacteraemia were cases and controls, respectively. RESULTS: Bacteraemia was detected in 72 (3.1%) of 2,306 hospital visits. Non-typhoidal Salmonella (NTS; n = 24; 33.3%) and Salmonella typhi (n = 18; 25.0%) were the most common isolates. Logistic regression analysis showed that bacteraemia was negatively associated with urbanicity (odds ratio [OR] = 0.8; 95% confidence interval [CI]: 0.7–1.0) and socio-economic status (OR = 0.8; 95% CI: 0.6–0.9). Both associations were stronger if only NTS infections were used as cases (OR = 0.5; 95% CI: 0.3–0.8 and OR = 0.6; 95% CI: 0.4–1.0, respectively). CONCLUSIONS: The results of this study highlight the importance of individual as well as community factors as independent risk factors for invasive bacterial infection (IBI) and especially NTS. Epidemiological data support physicians, public health experts and policy makers to identify disease prevention and treatment needs in order to secure public health in the transitional societies of developing countries. Public Library of Science 2015-09-29 /pmc/articles/PMC4587855/ /pubmed/26418004 http://dx.doi.org/10.1371/journal.pone.0139433 Text en © 2015 Sothmann et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Sothmann, Peter
Krumkamp, Ralf
Kreuels, Benno
Sarpong, Nimako
Frank, Clemens
Ehlkes, Lutz
Fobil, Julius
Gyau, Kennedy
Jaeger, Anna
Bosu, Benedicta
Marks, Florian
Owusu-Dabo, Ellis
Salzberger, Bernd
May, Jürgen
Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural-Urban Transition Zone
title Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural-Urban Transition Zone
title_full Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural-Urban Transition Zone
title_fullStr Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural-Urban Transition Zone
title_full_unstemmed Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural-Urban Transition Zone
title_short Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural-Urban Transition Zone
title_sort urbanicity and paediatric bacteraemia in ghana—a case-control study within a rural-urban transition zone
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4587855/
https://www.ncbi.nlm.nih.gov/pubmed/26418004
http://dx.doi.org/10.1371/journal.pone.0139433
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