Urbanicity and Paediatric Bacteraemia in Ghana-A Case-Control Study within a Rural-Urban Transition Zone
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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.
In: PLOS ONE, Vol. 10, No. 9, 29.09.2015, p. e0139433.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Urbanicity and Paediatric Bacteraemia in Ghana-A Case-Control Study within a Rural-Urban Transition Zone
AU - Sothmann, Peter
AU - Krumkamp, Ralf
AU - Kreuels, Benno
AU - Sarpong, Nimako
AU - Frank, Clemens
AU - Ehlkes, Lutz
AU - Fobil, Julius
AU - Gyau, Kennedy
AU - Jaeger, Anna
AU - Bosu, Benedicta
AU - Marks, Florian
AU - Owusu-Dabo, Ellis
AU - Salzberger, Bernd
AU - May, Jürgen
PY - 2015/9/29
Y1 - 2015/9/29
N2 - 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.
AB - 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.
KW - Bacteremia
KW - Bacteria
KW - Case-Control Studies
KW - Child
KW - Child, Preschool
KW - Cities
KW - Female
KW - Ghana
KW - Humans
KW - Infant
KW - Logistic Models
KW - Male
KW - Principal Component Analysis
KW - Rural Health
KW - Rural Population
KW - Salmonella
KW - Salmonella Infections
KW - Salmonella typhi
KW - Social Class
KW - Urban Health
KW - Urban Population
KW - Urbanization
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1371/journal.pone.0139433
DO - 10.1371/journal.pone.0139433
M3 - SCORING: Journal article
C2 - 26418004
VL - 10
SP - e0139433
JO - PLOS ONE
JF - PLOS ONE
SN - 1932-6203
IS - 9
ER -