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Invasive salmonellosis in Malawi

Melita A Gordon1, Stephen M Graham

  • 1Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Blantyre, Malawi. magordon@liverpool.ac.uk

Journal of Infection in Developing Countries
|September 12, 2009
PubMed

Insights

Invasive salmonellosis, including drug-resistant strains, is rising in Malawi, particularly in children and HIV patients. Typhoid fever incidence is decreasing, with Salmonella Typhi remaining sensitive to antibiotics.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Epidemiology

Background:

  • Invasive salmonellosis incidence is increasing in Malawi, affecting children and HIV-infected adults.
  • This rise is linked to drug resistance in non-typhoidal Salmonella serovars Enteritidis and Typhimurium.
  • Conversely, Salmonella Typhi (S. Typhi) remains sensitive to antibiotics, with a slight decrease in typhoid fever incidence.

Purpose of the Study:

  • To investigate the changing epidemiology of invasive salmonellosis in Malawi.
  • To understand the factors contributing to the emergence of drug resistance in non-typhoidal Salmonella.
  • To highlight the need for improved understanding and vaccine development for salmonellosis.

Main Methods:

  • Epidemiological surveillance of invasive salmonellosis cases.
  • Antimicrobial susceptibility testing of Salmonella isolates.
  • Analysis of trends in non-typhoidal Salmonella and S. Typhi infections.

Main Results:

  • Increased incidence of invasive salmonellosis and drug resistance in non-typhoidal Salmonella (Enteritidis, Typhimurium).
  • Decreased incidence of typhoid fever, with S. Typhi isolates remaining fully sensitive to antibiotics.
  • Non-typhoidal Salmonella may be adapting to human transmission in immunosuppressed populations.

Conclusions:

  • The emergence of drug-resistant non-typhoidal Salmonella poses a significant public health threat in Malawi.
  • Understanding the epidemiology of invasive salmonellosis is crucial for effective control and prevention strategies.
  • Vaccine development for Salmonella is urgently needed given the high mortality and increasing resistance.

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