Infectious Diseases

Statement of the Problem: Salmonellosis is one of the most common bacterial diarrheal illnesses among children and poses a significant public health burden worldwide; despite this fact, data on non-typhoidal Salmonella spp in Iraq are limited. The current study therefore aimed to determine the prevalence, clinical presentation, serotype and antimicrobial resistance profiles, and risk factors associated with Salmonella infection in children in Thi-Qar province, south-eastern Iraq. Methodology & Theoretical Orientation: This hospital-based cross-sectional study among children aged less than 5 years presenting with diarrhoea at paediatrics hospitals. Stool samples were identified using conventional and molecular methods. Antimicrobial susceptibility testing was performed using disk diffusion method. The associations between stool-culture positivity for Salmonella spp. and risk factors were assessed by Odds Ratio (OR), and 95% Confidence Intervals (CIs) was considered significant at P-value ≤ 0.05. Findings: From 320 diarrhea cases enrolled between March and August 2016, 33 (10.3%) diarrhea cases were stool culture-positive for non-typhoidal Salmonella. Resistance was most commonly detected against tetracycline (78.8%), azithromycin (66.7%), and ciprofloxacin (60.6%). The multivariable logistic regression analysis indicated that higher odd of Salmonella infection in children from household associated with untreated water (pipe water) (OR= 4.7 (95% CI: 1.6, 13.9), exposure to domestic animals (OR= 10.5; 95% CI: 3.8, 28.4) and low education level of the caregiver (OR= 3.9; 95% CI: 1.0, 6.4). Lower odd of Salmonella infection were associated with children exclusively breastfed (OR= 0.4; 95% CI: 0.1, 0.9) and caregiver those always washing hands after cleaning child defecation (95% CI: 0.1, 0.7). Conclusion & Significance: Our findings indicate that Salmonella is an important cause of children diarrhea in this setting. This work provides local, specific epidemiological data which are crucial to understand and combat pediatric diarrhea in Iraq.