Invasive Salmonellosis in Malawi

ABSTRACT

The incidence of invasive salmonellosis has increased among children and HIV-infected adults in Malawi. This has been associated with the emergence of drug resistance in the non-typhoidal Salmonella serovars Enteritidis and Typhimurium. In contrast; S. Typhi isolates have remained fully sensitive to commonly used antibiotics and the estimated incidence of typhoid fever; although still present; has fallen slightly among both adults and children. Infection with S. Typhi is not closely associated with underlying immuno- suppression but it is possible that the non-typhoidal Salmonellae have adapted to the person-person human transmission niche in this frequently immunosuppressed population. The huge burden of invasive salmonellosis in Malawi; the high associated mortality; and the recent emergence of drug resistance emphasise the need for a better understanding of the epidemiology and the need for vaccine development