Complications and mortality of non-typhoidal salmonella invasive disease: a global systematic review and meta-analysis
Christian S. Marchello, Megan Birkhold, John A. Crump, Laura Martín, Michael Owusu-Ansah, Gianluca Breghi, Rocı́o Canals, Fabio Fiorino, Melita A. Gordon, Jong‐Hoon Kim, Mainga Hamaluba, Brama Hanumunthadu, Jan Jacobs, Samuel Kariuki, Stefano Malvolti, Carsten Mantel, Florian Marks, Donata Medaglini, Vittal Mogasale, Chisomo Msefula, Esther Muthumbi, Tonney S. Niyrenda, Robert Onsaŕe, Ellis Owusu‐Dabo, Elena Pettini, Maheshi Ramasamy, Bassiahi A. Soura, Tiziana Spadafina, Bieke Tack
Abstract
BACKGROUND: Non-typhoidal salmonella can cause serious, life-threatening invasive infections involving the bloodstream and other normally sterile sites. We aimed to systematically review the prevalence of complications and case-fatality ratio (CFR) of non-typhoidal salmonella invasive disease to provide contemporary global estimates and inform the development of vaccine and non-vaccine interventions. METHODS: . This study was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and is registered with PROSPERO, CRD42020202293. FINDINGS: >80%) was observed in most (15 [65·2%] of 23) CFR estimates. INTERPRETATION: Complications were frequent among individuals with non-typhoidal salmonella invasive disease and approximately 15% of patients died. Clinicians, especially in African countries, should be aware of non-typhoidal salmonella invasive disease as a cause of severe febrile illness. Prompt diagnoses and management decisions, including empiric antimicrobial therapy, would improve patient outcomes. Additionally, investments in improving clinical microbiology facilities to identify non-typhoidal salmonella and research efforts towards vaccine development and non-vaccine prevention measures would prevent non-typhoidal salmonella invasive disease-associated illness and death. FUNDING: EU Horizon 2020 research and innovation programme.