ArticlePloS one2021
Epidemiology of Clostridioides difficile in South Africa.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
6 citing papers in PubMed, 6 citations in OpenAlex.
- Clostridioides difficile as a Zoonotic and Foodborne Pathogen: Reviewing the Global Evidence and South African Data.MicrobiologyOpen · 2026Review
- Clinical Characteristics and Risk Factors ofJournal of clinical medicine · 2026Article
- Changes in the Epidemiology of Clostridioides difficile Infection.Infectious disease clinics of North America · 2025Review
- Article
- Vaccination to Reduce Antimicrobial Resistance Burden-Data Gaps and Future Research.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Application of consolidated framework for implementation research to improve Clostridioides difficile infection management in district hospitals.Research in social & administrative pharmacy : RSAP · 2022Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClostridioides difficile (CD) is the most common healthcare-associated enteric infection. There is currently limited epidemiological evidence on CD incidence in South Africa.
aimTo estimate the burden of CD infection (CDI) in the South African public sector between 1 July 2016 and 30 June 2017.
methodsA retrospective cohort study utilizing secondary data was conducted to describe the epidemiology of CD in South Africa. We assessed the patient-level association between variables of interest, CD, and CD recurrence, by undertaking both univariate and multivariable analysis. Adjusted incidence rate ratios (aIRR) were calculated utilizing multivariable Poisson regression. The incidence of CD, CD recurrence and CD testing was estimated by Poisson regression for various levels of care and provinces.
resultsA total of 14 023 samples were tested for CD during the study period. After applying exclusion criteria, we were left with a sample of 10 053 of which 1 860 (18.50%) tested CD positive. A positive and significant association between CDI and level of care is found, with patients treated in specialized tuberculosis (TB) hospitals having a five-fold increased adjusted incidence risk ratio (aIRR) for CDI (aIRR 4.96 CI95% 4.08-6.04,) compared to those managed in primary care. Patients receiving care at a secondary, tertiary, or central hospital had 35%, 66% and 41% increased adjusted incidence of CDI compared to those managed in primary care, respectively. National incidence of CDI is estimated at 53.89 cases per 100 000 hospitalizations (CI95% 51.58-56.29), the incidence of recurrence at 21.39 (CI95% 15.06-29.48) cases per 1 000 cases and a recurrence rate of 2.14% (CI95% 1.51-2.94).
conclusionCompared to European countries, we found a comparable incidence of CD. However, our estimates are lower than those for the United States. Compared to high-income countries, this study found a comparatively lower CD recurrence.
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