Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural Urban Transition Zone

Background Systemic bacterial infections are a major cause of paediatric febrile illness in sub-Saharan Africa. Aim of this study was to assess the effects of social and geographical determinants on the risk of bacteraemia in a rural-urban transition zone in Ghana. Methods Children below 15 years of age with fever were recruited at an outpatient department in the suburban belt of Kumasi, Ghana’s second largest city. Blood was taken for bacterial culture and malaria diagnostics. The socio-economic status of participants was calculated using Principle Component Analysis. A scale, based on key urban characteristics, was estab lished to quantify urbanicity for all communities in the hospital catchment area. A case-con trol analysis was conducted, where children with and without bacteraemia were cases and controls, respectively. Results Bacteraemia was detected in 72 (3.1%) of 2,306 hospital visits. Non-typhoidal Salmonella (NTS; n = 24; 33.3%) and Salmonella typhi (n = 18; 25.0%) were the most common isolates. Logistic regression analysis showed that bacteraemia was negatively associated with urbanicity (odds ratio [OR] = 0.8; 95% confidence interval [CI]: 0.7–1.0) and socio-eco nomic status (OR = 0.8; 95% CI: 0.6–0.9). Both associations were stronger if only NTS infections were used as cases (OR = 0.5; 95% CI: 0.3–0.8 and OR = 0.6; 95% CI: 0.4–1.0, respectively).
This article is published by Plos One and is also available at https://doi.org/10.1371/journal.pone.0139433
Sothmann P, Krumkamp R, Kreuels B, Sarpong N, Frank C, Ehlkes L, et al. (2015) Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural-Urban Transition Zone. PLoS ONE 10(9): e0139433. doi:10.1371/ journal.pone.0139433