Last Updated: 10/06/2024
Predicting and treating non-typhoidal Salmonella bloodstream infection in children in sub-Saharan Africa
Objectives
As a first work-package of this research project, the epidemiology of non-typhoidal Salmonella bloodstream infections will be addressed. Salmonella is on the rise in DR Congo, which is in contrast to the decline of the global Salmonella burden.
Firstly, to understand the emerging pattern, the seasonal dynamics of Salmonella bloodstream infection incidence in relation to Plasmodium falciparum malaria incidence and environmental/climate factors will be analyzed in this project. Secondly, the focus will be on the clinical prediction of Salmonella bloodstream infections in children in an area of endemic Salmonella and Plasmodium falciparum malaria.
Unlike in Northern countries, where non-typhoidal Salmonella causes self-limiting diarrhea, non-typhoidal Salmonella is the most common cause of bacterial bloodstream infections in children in sub-Saharan Africa. Case fatality is between 20-30%. Susceptible hosts include children with Plasmodium falciparum (Pf) malaria, severe anemia, acute malnutrition, and HIV infected individuals. Salmonella bloodstream infections are difficult to diagnose due to their non-specific presentation mimicking severe malaria, causing both under- and overtreatment. Besides the fact that evidence-based treatment regimens are non-existent, adequate antibiotic treatment is challenging in resource-limited settings and in a context of rising antibiotic resistance. Further this project will develop a clinical diagnostic algorithm based on signs and symptoms and basic laboratory tests (hemoglobin, glycemia, malaria rapid diagnostic tests) in hospital admitted children and examine its validity at the primary care level. In addition, a proof-of-concept testing of salivary cortisol as biomarker for pediatric bloodstream infections will be performed in a Plasmodium falciparum endemic area. To conclude, this project will provide data to improve the evidence-based management of children admitted with suspected or confirmed Salmonella BSI.
Oct 2018 — Oct 2022
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