Risk Factors for Salmonella Infection in Children under Five Years: A Hospital-Based Study in Kilimanjaro Region, Tanzania

Abstract

Salmonella is among the causative agents for diarrhea worldwide, but its risk factors in Tanzanian children are poorly understood. A hospital-based cross-sectional study was conducted in Moshi, Kilimanjaro region, from July 2020 to November 2022 among children under five admitted with diarrhea. A questionnaire was administered to all parents/caretakers of the enrolled children. Logistic regression was utilized to analyze the risk factors, with significance at p < 0.05. A total of 306 children were enrolled in the study. The median age was 13.8 months (IQR 8.4–21.8). The majority (58.5%) were males, and 59.5% were from rural areas. Salmonella was identified in eight (2.6%) stool samples, with a higher prevalence in urban than rural areas (4.8% vs. 1.1%; p-value = 0.044). The significant risk factors associated with Salmonella infection among the children included consuming raw milk (adjusted OR = 30.19; 95% CI: 3.94–231.46), using infant formula (adjusted OR = 15.78; 95% CI: 2.98–83.56), undisclosed household income (adjusted OR = 9.98; 95% CI: 2.46–40.12), purchasing eggs direct from the farms (adjusted OR = 7.58; 95%CI: 1.31–43.96), and contact with chickens (adjusted OR = 6.49; 95%CI: 1.25–33.59). These findings highlight the need for targeted interventions to improve food safety, hygiene practices, and socioeconomic conditions.