Socio-demographic, host and clinical characteristics of people with typhoidal and non-typhiodal Salmonella gastroenteritis in urban Bangladesh

Sumon Kumar Das, Mohammod Jobayer Chisti, Mohammad Abdul Malek, Shahnawaz Ahmed, Fahmida Dil Farzana, Farzana Ferdous, K. M. Shahunja, Mohammed Abdus Salam, Tahmeed Ahmed, Abu Syed Golam Faruque

Centre for Nutrition and Food Security (CNFS), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.

DOI: 10.4236/jbise.2013.68101                

Abstract

Typhoidal (Salmonella enterica serover Typhi and Para-typhi A and B) (TS) and non-typhiodal Salmonella (NTS) gastroenteritis are less reported in Bangladesh. There is also a lack of report on socio-demographic and clinical characteristics of Bangladeshi people with typhoid fever and those with non-typhoidal Salmonella (NTS) gastroenteritis. Thus, the present study aimed to compare the socio-demographic, host and clinical characteristics, and seasonal variations between TS and NTS infections among patients attending at a large diarrheal disease hospital in urban Bangladesh. Information were extracted from the database of icddr,b in two different age stratums (0-14 years, and 15 years and above) as 54 with TS and 199 with NTS; and 65 with TS and 239 with NTS respectively after excluding all other pathogens. Randomly selected individuals with diarrhea but without any pathogen in stool constituted the control group (n = 253 and n = 304 respectively). Among 0-14 years, fever [aOR-4.35 (95% CI-1.45-13.06)] and drink unboiled water [aOR-0.22 (95% CI-0.06-0.83)] significantly differed between TS and NTS. Significant associations were observed with lower socio-economic context [aOR-10.02 (95% CI-3.79-26.45)], unbolied drinking water [aOR-2.16 (95% CI-1.05-4.43)], fever [aOR-4.54 (95% CI-1.71-12.03)], pneumonia [aOR-21.57 (95% CI-1.90-245.01)], wasting [aOR-2.60 (95% CI-1.21-5.57)], presence of RBC [aOR-0.09 (95% CI-0.02-0.33], leucocytes [aOR-3.97 (95% CI-1.76-8.99)] and macrophage [aOR-10.71 (95% CI-2.80-41.06)] in stool and alkaline pH [aOR-2.07 (95% CI-1.08-3.97)] when compared with control group. Among ≥15 years, TS was more frequently isolated from individuals with poor socio-economic background [aOR-2.09 (95% CI-1.0-4.33)] and use non-tap drinking water [aOR-0.29 (95% CI-0.13-0.66] compared to their NTS counterparts. Reported lack of formal schooling [aOR-0.65 (95% CI-0.44-0.96)], fever [aOR-2.10 (95% CI-1.03-4.31)], hospital stay (>24 hours) [aOR-1.66 (95% CI-1.05-2.62)], use of intravenous saline [aOR-0.50 (95% CI-0.34-0.76)] and RBC [aOR-2.34 (95% CI-1.23-4.45)] were associated with TS and NTS compared to control group. Socio-demographic, host and clinical characteristics between TS and NTS gastroenteritis were identical; however, findings significantly differed when compared with individuals presented with diarrhea but without any common enteric pathogen in stool.

Keywords

Bangladesh; Diarrhea; Non-Typhiodal Salmonella; Typhoidal Salmonella; Urban

Conflicts of Interest

The authors declare no conflicts of interest.

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