Campylobacter Infection in Children in Malawi Is Common and Is Frequently Associated with Enteric Virus Co-Infections |
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Authors: | Jenifer Mason Miren Iturriza-Gomara Sarah J. O’Brien Bagrey M. Ngwira Winifred Dove Martin C. J. Maiden Nigel A. Cunliffe |
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Affiliation: | 1. Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.; 2. Department of Community Health, College of Medicine, University of Malawi, Blantyre, Malawi.; 3. Department of Zoology, University of Oxford, Oxford, United Kingdom.; University of Aberdeen, United Kingdom, |
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Abstract: | BackgroundCampylobacter species are the most common cause of bacterial gastroenteritis in the developed world. However, comparatively few studies have determined the epidemiological features of campylobacteriosis in resource-poor settings.MethodsA total of 1,941 faecal specimens collected from symptomatic (diarrhoeic) children and 507 specimens from asymptomatic (non-diarrhoeic) children hospitalised in Blantyre, Malawi, between 1997 and 2007, and previously tested for the presence of rotavirus and norovirus, was analysed for C. jejuni and C. coli using a real time PCR assay.ResultsCampylobacter species were detected in 415/1,941 (21%) of diarrhoeic children, with C. jejuni accounting for 85% of all cases. The median age of children with Campylobacter infection was 11 months (range 0.1–55 months), and was significantly higher than that for children with rotavirus and norovirus (6 months and 7 months respectively; P<0.001). Co-infection with either rotavirus or norovirus was noted in 41% of all cases in the diarrhoeic group. In contrast, the detection rate of Campylobacter in the non-diarrhoeic group was 14%, with viral co-infection identified in 16% of children with Campylobacter. There was no association between Campylobacter detection rate and season over the 10 year period.DiscussionUsing molecular detection methodology in hospitalised Malawian children, we have demonstrated a high prevalence of Campylobacter infection, with frequent viral co-infection. The burden of Campylobacter infection in young African children may be greater than previously recognised. |
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