The Prevalence of Community Acquired Salmonellosis, Associated Factors and Antibiotic Susceptibility Among Out Patients Attending Kagando Hospital, Kasese District, Mid-western, Uganda

Abstract

Background: Uganda has experienced a number of typhoid fever out breaks, the most recent being in Kampala city in which 1,038 (29%) patients were positive out of 3464 suspected cases. In 2011, typhoid cases (1042) were reported in Kasese and neighboring Bundibugyo District with many more intestinal perforations (566) and with emergence of multidrug resistant strains. Objective: The study was conducted at Kagando hospital in Kasese district to determine the prevalence of community acquired Salmonellosis, evaluate antimicrobial susceptibility and document factors associated with salmonellosis. Methods: A cross sectional study was used to enroll 165 participants at Kagando hospital suspected of having salmonellosis. Data on demographics and risk factors were explored by the questionnaire. Venous blood and stool samples were taken from each participant to run a rapid test for Salmonella Typhi/ Paratyphi immunoglobulin M and G (IgM/IgG) and culture respectively. Results: Prevalence of Salmonellosis by Salmonella Typhi/Paratyphi IgM/IgG serological testing was 22% and 15.8% by culture of blood and stool. NTS accounted for a prevalence of 10.3% followed by S. Typhi 4.9% and then S. Paratyphi 0.61%. Most isolates were susceptible to levofloxacin, Gentamycin, Imipenem, Tetracycline and Cotrimoxazole. Most isolates were resistant to ampicillin, ceftriaxone and amoxicillin-clavulanic acid. Salmonellosis was associated with consumption of locally packed water, primary level of education, non-hand washing, history of gastric surgery and Helicobacter pylori treatment. Conclusion: Confirmed Community acquired salmonellosis exists among out patients attending Kagando hospital in Kasese district at a prevalence of 15.8% and a sero prevalence of 22%. Salmonellosis is associated with consumption of locally packed water, history of gastric surgery, primary level of education, Helicobacter pylori treatment and the practice of non-hand washing. Routine Culture and sensitivity is recommended for proper diagnosis and appropriate treatment of patients with clinical diagnosis of salmonellosis. Also sensitization on community acquired salmonellosis through health education programs should be considered.