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Published on: November 7, 2018
Risk factors of non-typhoidal Salmonella gastroenteritis in hospitalised young children: a case-control study
Pei Yee Woh1, May Pui Shan Yeung1, E Anthony S Nelson2
1Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region.
Insights
Food purchased from markets or restaurants, not supermarkets, significantly increases non-typhoidal Salmonella risk in Hong Kong children. Indoor playrooms may offer protection, but good hygiene is crucial to prevent gastroenteritis spread.
Area of Science:
- Pediatric Infectious Diseases
- Gastroenterology
- Public Health
Background:
- Non-typhoidal Salmonella gastroenteritis is a common childhood illness.
- Identifying risk factors is crucial for prevention strategies in young children.
Purpose of the Study:
- To investigate risk factors associated with non-typhoidal Salmonella gastroenteritis in children under five in Hong Kong.
- To inform public health interventions and parental guidance.
Main Methods:
- A case-control study was conducted in pediatric wards of three Hong Kong public hospitals.
- 102 cases of culture-confirmed non-typhoidal Salmonella gastroenteritis were compared with 204 age-matched controls.
- Data on food purchasing habits and other exposures were collected via standardized questionnaires and analyzed using multivariable logistic regression.
Main Results:
- Food purchased from wet markets, restaurants, or farms (non-supermarket sources) was a significant risk factor (aOR, 2.64).
- Household contact with gastroenteritis symptoms showed borderline significance (aOR, 2.03).
- Playing in children's indoor playrooms was a protective factor (aOR, 0.28).
Conclusions:
- Consumption of food from non-supermarket sources is a key determinant of non-typhoidal Salmonella gastroenteritis in young children in Hong Kong.
- Parents should be aware of food sourcing risks. The protective effect of indoor playrooms requires further investigation.
- Emphasis on good family hygiene is recommended to prevent person-to-person transmission.
Objective:
To explore risk factors associated with non-typhoidal Salmonella gastroenteritis in young children in Hong Kong.
Design:
A case-control study.
Setting:
Paediatrics wards at three public hospitals in Hong Kong.
Participants:
Cases were children aged above 30 days to below 5 years hospitalised for gastroenteritis at three public hospitals in Hong Kong with culture confirmed non-typhoidal Salmonella infection. Controls were age-matched (±2 months) children admitted for a reason other than gastroenteritis.
Main Outcomes Measures:
A face-to-face interview by using standardised questionnaire on exposures 3 days prior to illness. Adjusted OR (aORs) and 95% CIs were calculated using multivariable logistic regression.
Results:
A total of 102 cases and 204 age-matched controls were included in the analysis. Multivariable logistic regression revealed that having food purchased from places other than a supermarket, that is, from wet market/restaurant/farm (aOR, 2.64; 95% CI, 1.03 to 6.77; p=0.044) was a significant risk factor for non-typhoidal Salmonella infection. Having a household member with gastroenteritis symptoms (aOR, 2.03; 95% CI, 0.94 to 4.39; p=0.072) was of borderline significance and playing at a children's indoor playroom was a protective factor (aOR, 0.28; 95% CI, 0.09 to 0.85; p=0.024).
Conclusions:
Consumption of food purchased from places other than a supermarket was the identified determinant factor for non-typhoidal Salmonella gastroenteritis in Hong Kong. Parents/caregivers should be alerted to this risk when choosing foods for their young children. The protective effect of playing in an indoor playroom could be confounded by socioeconomic factors and further investigation is required to better understand its potential implication. There was some support for person-to-person transmission and good family hygiene needs to be emphasised.
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