ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2015
Three Epidemics of Invasive Multidrug-Resistant Salmonella Bloodstream Infection in Blantyre, Malawi, 1998-2014.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 6 of them syntheses that pooled it.
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Who cites it
73 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Risk Factors for Typhoid Fever: Systematic Review.JMIR public health and surveillance · 2025Pooled it
- Incidence of non-typhoidal Salmonella invasive disease: A systematic review and meta-analysis.The Journal of infection · 2021Pooled it
- Invasive non-typhoidal Salmonella infections in sub-Saharan Africa: a systematic review on antimicrobial resistance and treatment.BMC medicine · 2020Pooled it
- Prevalence and outcome of bloodstream infections due to third-generation cephalosporin-resistant Enterobacteriaceae in sub-Saharan Africa: a systematic review.The Journal of antimicrobial chemotherapy · 2020Pooled it
- Molecular epidemiology of fluoroquinolone resistant Salmonella in Africa: A systematic review and meta-analysis.PloS one · 2018Pooled it
- An Appraisal of the Clinical Features of Pediatric Enteric Fever: Systematic Review and Meta-analysis of the Age-Stratified Disease Occurrence.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Pooled it
- Safety and Efficacy of a Typhoid Conjugate Vaccine in Malawian Children.The New England journal of medicine · 2021Trial
- Typhoid Vaccine Acceleration Consortium Malawi: A Phase III, Randomized, Double-blind, Controlled Trial of the Clinical Efficacy of Typhoid Conjugate Vaccine Among Children in Blantyre, Malawi.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Trial
- Does plastic waste present an infection hazard? Current evidence, surveillance challenges and research priorities.One health outlook · 2026Review
- Rickettsia typhi seroprevalence among patients with unexplained acute fever at the Sourô Sanou University Hospital Center (SSUHC), Burkina Faso.BMC infectious diseases · 2026Article
- Development of a GMMA-based candidate vaccine against invasive nontyphoidalFrontiers in immunology · 2026Article
- Circulation of Salmonella spp. between humans, animals and the environment in animal-owning households in Malawi.Nature communications · 2025Article
- Indispensable role of AcrEF in modulating Salmonella virulence and disrupting host tight junctions to facilitate paracellular entry and invasion.Biology direct · 2025Article
- Non-typhoidal Salmonella combination vaccines: clinical development plan and regulatory considerations.Vaccine · 2025Review
- Non-typhoidal Salmonella transmission reservoirs in Sub-Saharan Africa: a genomic assessment from a one health perspective.Antimicrobial resistance and infection control · 2025Article
- AInfection and immunity · 2025Article
- Genomic epidemiology ofMicrobial genomics · 2025Article
- Effectiveness of iNTS vaccination in sub-Saharan Africa.Scientific reports · 2025Article
- Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in Malawi.Vaccine: X · 2024Article
- Vitamin A deficiency impairs neutrophil-mediated control of Salmonella via SLC11A1 in mice.Nature microbiology · 2024Article
13 more citing papers are in PubMed but not listed here.
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10 authors.
Funding
Abstract
backgroundThe Malawi Liverpool Wellcome Trust Clinical Research Programme (MLW) has routinely collected specimens for blood culture from febrile patients, and cerebrospinal fluid from patients with suspected meningitis, presenting to Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi, since 1998.
methodsWe present bloodstream infection (BSI) and meningitis surveillance data from 1998 to 2014. Automated blood culture, manual speciation, serotyping, and antimicrobial susceptibility testing were performed at MLW. Population data for minimum-incidence estimates in urban Blantyre were drawn from published estimates.
resultsBetween 1998 and 2014, 167,028 blood cultures were taken from adult and pediatric medical patients presenting to QECH; Salmonella Typhi was isolated on 2054 occasions (1.2%) and nontyphoidal Salmonella (NTS) serovars were isolated 10,139 times (6.1%), of which 8017 (79.1%) were Salmonella Typhimurium and 1608 (15.8%) were Salmonella Enteritidis. There were 392 cases of NTS meningitis and 9 cases of Salmonella Typhi meningitis. There have been 3 epidemics of Salmonella BSI in Blantyre; Salmonella Enteritidis from 1999 to 2002, Salmonella Typhimurium from 2002 to 2008, and Salmonella Typhi, which began in 2011 and was ongoing in 2014. Multidrug resistance has emerged in all 3 serovars and is seen in the overwhelming majority of isolates, while resistance to third-generation cephalosporins and fluoroquinolones is currently uncommon but has been identified.
conclusionsInvasive Salmonella disease in Malawi is dynamic and not clearly attributable to a single risk factor, although all 3 epidemics were associated with multidrug resistance. To inform nonvaccine and vaccine interventions, reservoirs of disease and modes of transmission require further investigation.
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