Cruz Espinoza Ligia M, Nichols Chelsea, Adu-Sarkodie Yaw, Al-Emran Hassan M, Baker Stephen, Clemens John D, Dekker Denise Myriam, Eibach Daniel, Krumkamp Ralf, Boahen Kennedy, Im Justin, Jaeger Anna, von Kalckreuth Vera, Pak Gi Deok, Panzner Ursula, Park Se Eun, Park Jin Kyung, Sarpong Nimako, Schütt-Gerowitt Heidi, Toy Trevor, Wierzba Thomas F, Marks Florian, May Jürgen
International Vaccine Institute, Seoul, Republic of Korea.
Kumasi Centre for Collaborative Research in Tropical Medicine, Ghana Institute of Medical Microbiology, University of Cologne.
Clin Infect Dis. 2016 Mar 15;62 Suppl 1:S17-22. doi: 10.1093/cid/civ787.
The Typhoid Fever Surveillance in Africa Program (TSAP) estimated adjusted incidence rates (IRs) for Salmonella enterica serovar Typhi and invasive nontyphoidal S. enterica serovars (iNTS) of >100 cases per 100 000 person-years of observation (PYO) for children aged <15 years in Asante Akim North Municipal (AAN), Ghana, between March 2010 and May 2012. We analyzed how much these rates differed between rural and urban settings.
Children recruited at the Agogo Presbyterian Hospital and meeting TSAP inclusion criteria were included in the analysis. Towns with >32 000 inhabitants were considered urban; towns with populations <5200 were considered rural. Adjusted IRs for Salmonella bloodstream infections were estimated for both settings. Setting-specific age-standardized incidence rates for children aged <15 years were derived and used to calculate age-standardized rate ratios (SRRs) to evaluate differences between settings.
Eighty-eight percent (2651/3000) of recruited patients met inclusion criteria and were analyzed. IRs of Salmonella bloodstream infections in children <15 years old were >100 per 100 000 PYO in both settings. Among rural children, the Salmonella Typhi and iNTS rates were 2 times (SRR, 2.2; 95% confidence interval [CI], 1.3-3.5) and almost 3 times (SRR, 2.8; 95% CI, 1.9-4.3) higher, respectively, than rates in urban children.
IRs of Salmonella bloodstream infections in children <15 years old in AAN, Ghana, differed by setting, with 2 to nearly 3 times higher rates in the less populated setting. Variations in the distribution of the disease should be considered to implement future studies and intervention strategies.
非洲伤寒热监测项目（TSAP）估计，2010年3月至2012年5月期间，加纳阿桑特阿基姆北市（AAN）15岁以下儿童中，伤寒沙门氏菌和侵袭性非伤寒沙门氏菌（iNTS）的校正发病率（IRs）超过每10万人年观察期（PYO）100例。我们分析了农村和城市地区这些发病率的差异程度。
纳入在阿戈戈长老会医院招募且符合TSAP纳入标准的儿童进行分析。居民超过32000人的城镇被视为城市；人口少于5200人的城镇被视为农村。估计了两种环境下沙门氏菌血流感染的校正发病率。得出特定环境下15岁以下儿童的年龄标准化发病率，并用于计算年龄标准化率比（SRRs），以评估不同环境之间的差异。
88%（2651/3000）的招募患者符合纳入标准并进行了分析。两种环境下15岁以下儿童沙门氏菌血流感染的发病率均超过每10万PYO 100例。在农村儿童中，伤寒沙门氏菌和iNTS的发病率分别比城市儿童高2倍（SRR，2.2；95%置信区间[CI]，1.3 - 3.5）和近3倍（SRR，2.8；95%CI，1.9 - 4.3）。
加纳AAN地区15岁以下儿童沙门氏菌血流感染的发病率因环境而异，人口较少地区的发病率高出2至近3倍。在实施未来研究和干预策略时应考虑疾病分布的差异。
