Date of Award

Spring 5-13-2016

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Daniel Whitaker, Ph.D.

Second Advisor

Hope Dishman, M.P.H

Third Advisor

Dr. Melissa Tobin-D'Angelo, M.D., M.P.H

Abstract

INTRODUCTION: The Centers for Disease Control and Prevention (CDC) estimates that approximately 1.2 million illnesses and 450 deaths occur annually in the United States from non-typhoidal Salmonella infections (CDC, 2015). Children are most likely to get salmonellosis; the elderly, infants, and those with compromised immune systems are likely to have a severe illness.

PURPOSE OF THE STUDY: In this study, an analysis of childhood salmonellosis comparing infants under 6 months and those 6 to 12 months old was completed. This analysis was conducted in order to compare exposures among the two age groups.

METHODS: Data were downloaded from SENDSS into Microsoft Excel for data cleaning; data management and analysis was conducted using R Statistical Packaging (R-3.2.3), Epi InfoTM 7 and Microsoft Excel 2016.

RESULTS: The occurrence of contact with dog was 43.59% among children under than 6 months and for children 6-12 months, the rate of contact with dog was 48.37% (OR=0.82, p =0.33); the incidence of exposure to bird was 1.54% for children under 6 months and among children 6-12 months, the incidence was 2.31% (OR=0.66, p = 0.57). In children under 6 months, the incidence of exposure to pig was 0% and among children 6-12 months, the rate of exposure was 0.46% (OR=0, p = 0.34); among children under 6 months, the occurrence of exposure to reptile/amphibian was 6.63% and between children 6-12 months, the rate of exposure was 3.67% (OR=1.86, p = 0.17). Among children younger than 6 months, the incidence of contact with cat was 11.40% and for children 6-12 months, the rate of exposure was 15.21% (OR=0.72, p = 0.26). The occurrence of contact with others with similar illness among children under 6 months was 18.18% and the incidence of contact with others for children 6-12 months was 23.53% (OR=0.72, p = 0.56); for children under 6 months, the rate of exposure to children in diapers was 44.75% and among children 6-12 months, the incidence was 45.77% (OR=0.96, p = 0.84). For children under 6 months, the incidence of attending large gatherings was 18.84% and between children 6-12 months, the rate of exposure to large gatherings was 22.64% (OR=0.79, p = 0.35). Among children under 6 months, the incidence of exposure to watermelon was 1.04% and between children 6-12 months, the rate of exposure was 10.95% (OR=0.086, p = <.0001); for children under 6 months, the rate of exposure to chicken was 2.06% and the incidence of contact with chicken among children 6-12 months was 35.85% (OR=0.0389, p = <.0001). The rate of exposure to tomatoes among children under 6 months was 0.52% and the incidence of exposure to tomatoes in children 6-12 months was 3.76% (OR=0.135, p = 0.028); among infants under 6 months, the rate of exposure to dairy was 3.66% and for children 6-12 months, the occurrence of exposure to dairy was 26.29% (OR=0.107, p = <.0001). In children under 6 months, the incidence of exposure to berries was 0.52% and the rate of exposure to berries among children 6-12 months was 13.46% (OR=0.034, p = <.0001); the incidence of exposure to turkey among children under 6 months was 0.52% and in children 6-12 months, it was 12.38% (OR=0.037, p = <.0001). The rate of exposure to beef in children under 6 months was 1.04% and in children 6-12 months, it was 10% (OR=0.094, p = <.0001).

DISCUSSION AND CONCLUSION: There was no significant difference in the incidence of animal exposures for salmonellosis among children under 6 months and 6 to 12 months in Georgia. Moreover, there was no significant difference between environmental exposures among children under 6 months and 6-12 months. Nonetheless, we did find statistically significant difference in food exposures among infants under 6 months and those over 6-12 months. Our finding suggests that when compared to children 6-12 months, infants under 6 months are less likely to have been exposed to food items other than infant formula or breast milk.

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