Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Nov;66(7):701-728.
doi: 10.1111/zph.12631. Epub 2019 Jul 16.

Prevalence of enteric non-typhoidal Salmonella in humans in the Middle East and North Africa: A systematic review and meta-analysis

Rami H Al-Rifai  1 , Karima Chaabna  2 , Thomas Denagamage  3 , Walid Q Alali  4
Affiliations
Meta-Analysis

Prevalence of enteric non-typhoidal Salmonella in humans in the Middle East and North Africa: A systematic review and meta-analysis

Rami H Al-Rifai et al. Zoonoses Public Health. 2019 Nov.

Abstract

To enhance efforts related to controlling foodborne pathogens in the Middle East and North Africa (MENA), information on epidemiology of non-typhoidal Salmonella enterica (hereafter termed "Salmonella") is limited. We quantified the overall regional and country-specific Salmonella prevalence in different human populations and identified the most common serotypes. Published literature of Salmonella prevalence was systematically reviewed and reported following the Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Pooled Salmonella prevalence measures were estimated using a random-effects model. We identified 46 research reports that reported 84 Salmonella prevalence measures in 15 out of 24 countries in MENA. There were 252,831 tested humans with 6,356 Salmonella-positive cases. The pooled Salmonella prevalence in MENA was estimated at 6.6% (95% confidence interval (CI): 5.4%-7.9%). The highest pooled Salmonella prevalence measures were in Morocco (17.9%, 95% CI: 5.7%-34.8%, 1997-2012), Tunisia (10.2%, 95% CI: 4.3%-18.0%, 1988-2009) and Sudan (9.2%, 95% CI: 6.5%-12.2%, 2006-2008), while the lowest were in Jordan (1.1%, 95% CI: 0.1%-3.0%, 1993-2010), Oman (1.2%, 95% CI: 1.2%-1.3%, 1998-2002) and Palestine (1.2%, 95% CI: 0.4%-2.1%, 1999-2011). In MENA, Salmonella pooled prevalence in gastrointestinal symptomatic, gastrointestinal asymptomatic and food handlers population groups was 13.0% (95% CI: 7.6%-19.6%), 11.4% (95% CI: 2.2%-25.7%) and 3.8% (95% CI: 1.0%-8.0%), respectively. Salmonella prevalence was 14.5% (95% CI: 8.7%-26.1%) in studies tested <100 subjects, whereas 4.6% (95% CI: 3.6%-5.8%) in studies tested ≥100 subjects. Salmonella Enteritidis (29.8%) and Typhimurium (23.6%) were the most common serotypes. Salmonella was a common foodborne pathogen in MENA countries, particularly in North African countries. Findings inform the scientific community, the public and the decision-makers with Salmonella prevalence and gaps in evidence in MENA to support control and prevention strategies and could leverage more research studies.

Keywords: Salmonella; MENA region; Middle East and North Africa; human; meta-analyses; non-typhoidal Salmonella; prevalence; systematic review.

PubMed Disclaimer

References

REFERENCES

    1. Abbassi-Ghozzi, I., Jaouani, A., Aissa, R. B., Martinez-Urtaza, J., Boudabous, A., & Gtari, M. (2011). Antimicrobial resistance and molecular analysis of non-typhoidal Salmonella isolates from human in Tunisia. Pathologie Biologie, 59(4), 207-212. https://doi.org/10.1016/j.patbio.2010.06.001
    1. Abdel-Dayem, M., Al Zou'bi, R., Hani, R. B., & Amr, Z. S. (2014). Microbiological and parasitological investigation among food handlers in hotels in the Dead Sea area, Jordan. Journal of Microbiology, Immunology, and Infection, 47(5), 377-380. https://doi.org/10.1016/j.jmii.2013.06.001
    1. Abu Elamreen, F. H., Abed, A. A., & Sharif, F. A. (2007). Detection and identification of bacterial enteropathogens by polymerase chain reaction and conventional techniques in childhood acute gastroenteritis in Gaza, Palestine. International Journal of Infectious Diseases, 11(6), 501-507. https://doi.org/10.1016/j.ijid.2007.01.010
    1. Abu Elamreen, F. H., Sharif, F. A., & Deeb, J. E. (2008). Isolation and antibiotic susceptibility of Salmonella and Shigella strains isolated from children in Gaza, Palestine from 1999 to 2006. Journal of Gastroenterology and Hepatology, 23(8 Pt 2), e330-e333.
    1. Ahn, E., & Kang, H. (2018). Introduction to systematic review and meta-analysis. Korean Journal of Anesthesiology, 71(2), 103-112. https://doi.org/10.4097/kjae.2018.71.2.103

Publication types