Urbanicity and Paediatric Bacteraemia in Ghana—A Case-Control Study within a Rural Urban Transition Zone
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Date
2015
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PLOS ONE
Abstract
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).
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This article is published by Plos One.
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Citation
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