https://doi.org/10.4081/ijfs.2026.14586
Non-typhoidal Salmonella prevalence and risk factors among outpatients at public health facilities in Gondar City, northwest Ethiopia
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Published: 9 February 2026
Non-typhoidal Salmonella is a major cause of foodborne illness, particularly in developing countries where poor hygiene and consumption of unsafe food or water are common, yet data on its prevalence and associated risk factors are limited in the study area. This study aimed to determine the prevalence and related risk factors of non-typhoid Salmonella among diarrheal patients attending health institutions in Gondar City. A cross-sectional study was conducted from September 2024 to August 2025, involving 432 patients with diarrhea who visited selected public health facilities. Stool samples were tested using standard microbiological and biochemical methods, and data on potential risk factors were collected through a structured questionnaire. Non-typhoid Salmonella was detected in 12 patients (2.8%). Significant predictors of infection included consuming raw vegetables and fruits [adjusted odds ratio (AOR)=4.00; 95% confidence interval (CI): 1.41-16.15], leaving food unrefrigerated for more than 2 hours (AOR=4.00; 95% CI: 1.31-18.46), contact with livestock (AOR=7.00; 95% CI: 1.91-26.90), and limited access to proper toilet facilities (AOR=11.00; 95% CI: 3.55-38.29). On the other hand, access to clean water was associated with a significantly lower risk of infection (AOR=0.12; 95% CI: 0.04-0.39). Although the prevalence was lower than global averages, the presence of multiple risk factors suggests ongoing transmission, indicating the need for improved hygiene, better food safety practices, and regular monitoring of non-typhoid Salmonella in the area.
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Abate D, Assefa N, 2021. Prevalence and antimicrobial resistance patterns of Salmonella isolates in human stools and animal origin foods in Ethiopia: a systematic review and meta-analysis. Int J Health Sci 15:43-55.
Abdulhaleem N, Garba B, Younis H, Mahmuda A, Hamat RA, Majid RBA, Lung LTT, Unyah NZ, Sattar A, Saidu B, 2019. Current trend on the economic and public health significance of salmonellosis in Iraq. Adv Anim Vet Sci 7:484-91.
Amare A, Asnakew F, Asressie Y, Guadie E, Tirusew A, Muluneh S, Awoke A, Assefa M, Ferede W, Getaneh A, Lemma M, 2024. Prevalence of multidrug resistance Salmonella species isolated from clinical specimens at University of Gondar comprehensive specialized hospital Northwest Ethiopia: a retrospective study. PLoS One 19:e0301697.
Azanaw A, Setegn E, Ayenew A, Desie K, Wondwossen A, Feleke M, 2024. Prevalence of Salmonella spp., Shigella spp., and intestinal parasites among food handlers working in University of Gondar student's cafeteria, Northwest Ethiopia. Front Public Health 12:1370338.
Balasubramanian R, Im J, Lee JS, Jeon HJ, Mogeni OD, Kim JH, Rakotozandrindrainy R, Baker S, Marks F, 2019. The global burden and epidemiology of invasive non-typhoidal Salmonella infections. Hum Vaccin Immunother 15:1421-6.
Bedassa A, Nahusenay H, Asefa Z, Sisay T, Girmay G, Kovac J, Vipham JL, Zewdu A, 2023. Prevalence and associated risk factors for Salmonella enterica contamination of cow milk and cottage cheese in Ethiopia. Int J Food Contam 10:2.
Beyene AM, Alemie Y, Gizachew M, Yousef AE, Dessalegn B, Bitew AB, Alemu A, Gobena W, Christian K, Gelaw B, 2024. Serovars, virulence factors, and antimicrobial resistance profile of non-typhoidal Salmonella in the human-dairy interface in Northwest Ethiopia: a one health approach. PLoS Negl Trop Dis 18:e0012646.
Beyene G, Nair S, Asrat D, Mengistu Y, Engers H, Wain J, 2010. Multidrug resistant Salmonella Concord is a major cause of salmonellosis in children in Ethiopia. J Infect Dev Ctries 5:23-33.
Cheni J, Ed-Dra A, Zhou H, Wu B, Zhang Y, Yue M, 2022. Antimicrobial resistance and genomic investigation of non-typhoidal Salmonella isolated from outpatients in Shaoxing city, China. Front Public Health 10:988317.
Cuco A, Mkupasi E, Mzula A, Mdegela R, 2024. Non-typhoidal Salmonella contributes to gastrointestinal infections in Morogoro: Evidence from patients attending Morogoro regional referral hospital in Tanzania. PLoS Negl Trop Dis 18:e0012249.
Cuypers WL, Meysman P, Weill FX, Hendriksen RS, Beyene G, Wain J, Nair S, Chattaway MA, Perez-Sepulveda BM, Ceyssens PJ, de Block T, Lee WWY, Pardos de la Gandara M, Kornschober C, Moran-Gilad J, Veldman KT, Cormican M, Torpdahl M, Fields PI, Černý T, Hardy L, Tack B, Mellor KC, Thomson N, Dougan G, Deborggraeve S, Jacobs J, Laukens K, Van Puyvelde S, 2023. A global genomic analysis of Salmonella Concord reveals lineages with high antimicrobial resistance in Ethiopia. Nat Commun 14:3517.
Degaga B, Sebsibe I, Belete T, Asmamaw A, 2022. Microbial Quality and Safety of Raw Vegetables of Fiche Town, Oromia, Ethiopia. J Environ Public Health 2022:2556858.
Dessale M, Mengist H, Mengistu G, 2023. Prevalence, antimicrobial resistance pattern, and associated factors of Salmonella and Shigella among under five diarrheic children attending public health facilities in Debre Markos town, northwest Ethiopia. Front Public Health 112:1114223.
Diab MS, Thabet AS, Elsalam MA, Ewida RM, Sotohy SA, 2023. Detection of virulence and β-lactamase resistance genes of non-typhoidal Salmonella isolates from human and animal origin in Egypt "one health concern". Gut Pathog 15:16.
Ehuwa O, Jaiswal AK, Jaiswal S, 2021. Salmonella, food safety and food handling practices. Foods 10:907.
Ejo M, Garedew L, Alebachew Z, Worku W, 2016. Prevalence and antimicrobial resistance of Salmonella isolated from animal-origin food items in Gondar, Ethiopia. Biomed Res Int 2016:4290506.
Elhadi N, Aljindan R, Aljeldah M, 2013. Prevalence of nontyphoidal Salmonella serogroups and their antimicrobial resistance patterns in a university teaching hospital in Eastern Province of Saudi Arabia. Infect Drug Resist 6:199-205.
Garedew L, Solomon S, Worku Y, Worku H, Gemeda D, Lelissa G, Mamuye Y, Abubeker R, Mihret A, Fentaw S, Worku A, Bahiru M, Erenso G, 2018. Diagnosis and Treatment of human salmonellosis in Addis Ababa City, Ethiopia. BioMed Res Int 2018;6406405.
Gazu L, Alonso S, Mutua F, Roesel K, Lindahl JF, Amenu K, Sousa FM, Ulrich P, Guadu T, Dione M, Ilboudo G, Knight-Jones T, Grace D, 2023. Foodborne disease hazards and burden in Ethiopia: A systematic literature review, 1990–2019. Front Sustain Food Syst 7:1058977.
Hailu W, Alemayehu H, Wolde D, Hailu L, Medhin G, Rajashekara G, Gebreye WA, Eguale T, 2024. Prevalence and antimicrobial susceptibility profile of Salmonella isolated from vegetable farms fertilized with animal manure in Addis Ababa Ethiopia. Sci Rep 14:19169.
Hayamo M, Alemayehu T, Tadesse B, Mitiku E, Bedawi Z, 2021. Magnitude, risk factors and antimicrobial susceptibility pattern of Shigella and Salmonella, among children with diarrhea in Southern Ethiopia: a Cross-sectional Study. SAGE Open Med 9:20503121211009729.
He Y, Wang J, Zhang R, Chen L, Zhang H, Qi X, Chen J, 2023. Epidemiology of foodborne diseases caused by Salmonella in Zhejiang Province, China, between 2010 and 2021. Front Public Health 11:1127925.
Hugho EA, Mmbaga BT, Lukambagire AHS, Kinabo GD, Thomas KM, Kumburu HH, Hald T, 2024. Risk factors for salmonella infection in children under five years: a hospital-based study in Kilimanjaro Region, Tanzania. Pathogens 13:798.
Im J, Nichols C, Bjerregaard-Andersen M, Sow AG, Lofberg S, Tall A, Pak GD, Aaby P, Baker S, Clemens JD, Cruz Espinoza LM, Konings F, May J, Monteiro M, Niang A, Panzner U, Park SE, Schütt-Gerowitt H, Wierzba TF, Marks F, von Kalckreuth V, 2016. Prevalence of Salmonella excretion in stool: a community survey in 2 sites, Guinea-Bissau and Senegal. Clin Infect Dis 62:S50-5.
Johnson R, Mylona E, Frankel G, 2018. Typhoidal Salmonella: distinctive virulence factors and pathogenesis. Cell Microbiol 20:e12939.
Kahsay AG, Dejene TA, Kassaye E, 2023. A systematic review on prevalence, serotypes and antibiotic resistance of Salmonella in Ethiopia, 2010-2022. Infect Drug Resist 16:6703-15.
Kebede R, Alemayehu H, Medhin G, Eguale T, 2021. Nontyphoidal Salmonella and their antimicrobial susceptibility among diarrheic patients attending private hospitals in Addis Ababa, Ethiopia. Biomed Res Int 2021:6177741.
Kim KG, Jung J, Shin JH, Park HJ, Kim MJ, Seo JJ, Kim YO, Lee SY, Cho CY, Kim TS, 2022. Trends in ESBLs and PABLs among enteric Salmonella isolates from children in Gwangju, Korea: 2014-2018. J Microbiol Immunol Infect 55:199-206.
Kivali V, Roesel K, Dohoo I, Alinaitwe L, Bugeza JK, Hoona JJ, Rwabiita Mugizi D, Kankya C, Dang-Xuan S, Szabo I, Rösler U, Friese A, Cook EAJ, 2024. Non-typhoidal Salmonella among slaughterhouse workers and in the pork value chain in selected districts of Uganda. Front Vet Sci 11:1427773.
Kumar G, Kumar S, Dutta J, Shidiki A, Jangid H, 2025. The rise of non-typhoidal Salmonella: an emerging global public health concern. Front Microbiol 16:1524287.
Lamichhane B, Mawad AMM, Saleh M, Kelley WG, Harrington PJ 2nd, Lovestad CW, Amezcua J, Sarhan MM, El Zowalaty ME, Ramadan H, Morgan M, Helmy YA, 2024. Salmonellosis: an overview of epidemiology, pathogenesis, and innovative approaches to mitigate the antimicrobial resistant infections. Antibiotics 13:76.
Liu H, Whitehouse CA, Li B, 2018. Presence and persistence of Salmonella in water: the impact on microbial quality of water and food safety. Front Public Health 6:159.
Liu M, Zhu K, Li X, Han Y, Yang C, Liu H, Du X, Xu X, Yang H, Song H, Qiu S, Xiang Y, 2023. Genetic characterization of a Salmonella enterica serovar Typhimurium isolated from an infant with concurrent resistance to ceftriaxone, ciprofloxacin and azithromycin. J Glob Antimicrob Resist 35:252-6.
Marks F, von Kalckreuth V, Aaby P, Adu-Sarkodie Y, El Tayeb MA, Ali M, Aseffa A, Baker S, Biggs HM, Bjerregaard-Andersen M, Breiman RF, Campbell JI, Cosmas L, Crump JA, Cruz Espinoza LM, Deerin JF, Dekker DM, Fields BS, Gasmelseed N, Hertz JT, Van Minh Hoang N, Im J, Jaeger A, Jeon HJ, Parfait Kabore L, Keddy KH, Konings F, Krumkamp R, Ley B, Valborg Løfberg S, May J, Meyer CG, Mintz ED, Montgomery JM, Niang AA, Nichols C, Olack B, Pak GD, Panzner U, Park JK, Park SE, Rabezanahary H, Rakotozandrindrainy R, Raminosoa TM, Razafindrabe TJL, Sampo E, Schütt-Gerowitt H, Sow AG, Sarpong N, Seo HJ, Sooka A, Bassiahi Soura A, Tall A, Teferi M, Thriemer K, Warren MR, Yeshitela B, Clemens JD, Wierzba TF, 2017. Incidence of invasive salmonella disease in sub-Saharan Africa: a multicentre population-based surveillance study. Lancet Glob Health 5:e310-23.
Mengistu G, Dejenu G, Tesema C, Arega B, Awoke T, Alemu K, Moges F, 2020. Epidemiology of streptomycin resistant Salmonella from humans and animals in Ethiopia: a systematic review and meta-analysis. PLoS One 15:e0244057.
Mohamed MYI, Habib I, 2025. Virulence gene landscapes of Salmonella in eastern and southern Africa. Front Microbiol 16:1631550.
Mukherjee N, Nolan VG, Dunn JR, Banerjee P, 2020. Exposures associated with non-typhoidal salmonella infections caused by Newport, Javiana, and Mississippi Serotypes in Tennessee, 2013-2015: a case-case analysis. Pathogens 9:78.
Muthumbi EM, Mwanzu A, Mbae C, Bigogo G, Karani A, Mwarumba S, Verani JR, Kariuki S, Scott JAG, 2023. The epidemiology of fecal carriage of nontyphoidal Salmonella among healthy children and adults in three sites in Kenya. PLoS Negl Trop Dis 17:e0011716.
Ngogo FA, Joachim A, Abade AM, Rumisha SF, Mizinduko MM, Majigo MV, 2020. Factors associated with Salmonella infection in patients with gastrointestinal complaints seeking health care at Regional Hospital in Southern Highland of Tanzania. BMC Infect Dis 20:135.
Nikiema MEM, Pardos de la Gandara M, Compaore KAM, Ky Ba A, Soro KD, Nikiema PA, Barro N, Sangare L, Weill FX, 2021. Contamination of street food with multidrug-resistant Salmonella, in Ouagadougou, Burkina Faso. PLoS One 16:e0253312.
Okullo JO, Moturi WN, Ogendi GM, 2017. Open defaecation and its effects on the bacteriological quality of drinking water sources in Isiolo county, Kenya. Environ Health Insights 11:1178630217735539.
Peter SK, Mutiso JM, Ngetich M, Mbae C, Kariuki S, 2023. Seroprevalence of non-typhoidal Salmonella disease and associated factors in children in Mukuru settlement in Nairobi County, Kenya. PLoS One 18:e0288015.
Petrin S, Orsini M, Massaro A, Olsen JE, Barco L, Losasso C, 2023. Phenotypic and genotypic antimicrobial resistance correlation and plasmid characterization in Salmonella spp. isolates from Italy reveal high heterogeneity among serovars. Front Public Health 11:1221351.
Siddiky NA, Sarker S, Kafi A, Samad MA, 2022. Virulence and antimicrobial resistance profile of non-typhoidal Salmonella enterica serovars recovered from poultry processing environments at wet markets in Dhaka, Bangladesh. PLoS One 17:e0254465.
Simion T, Abate A, Alemayehu T, Ali MM, 2024. Prevalence of Salmonella Typhi, its associated factors and antimicrobial susceptibility profile among patients attending Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia. BMC Infect Dis 24:1224.
Suhas S, Manjunatha N, Kumar CN, Benegal V, Rao GN, Varghese M, Gururaj G, 2023. Firth's penalized logistic regression: a superior approach for analysis of data from India's National Mental Health Survey, 2016. Indian J Psychiatry 65:1208-13.
Susanna D, Purwanisari E, Ratih SP, 2020. Salmonella infection among food handlers at canteens in a campus. Open Microbiol J 14:213-7.
Teshale AM, Abegaz WE, Azmeraye BM, Degefaw D, LaPolt D, Bonger Z, Kalayu AA, Tigabu E, Gazu L, Yimer G, Abate E, Tsige E, Tasew G, Dessie Y, Biks G, Barkley JA, Garsow AV, Beckiewicz A, Alonso S, Kowalcyk B, 2025. Prevalence of Shiga toxin-producing Escherichia coli, Salmonella, and Campylobacter species among diarrheal patients from three major hospitals in Ethiopia. PLOS Glob Public Health 5:e0004407.
Woh PY, Yeung MPS, Goggins WB, Lo N, Wong KT, Chow V, Chau KY, Fung K, Chen Z, Ip M, 2021. Genomic epidemiology of multidrug-resistant nontyphoidal Salmonella in young children hospitalized for gastroenteritis. Microbiol Spectr 9:e0024821.
Zeynudin A, Degefa T, Belay T, Mumicha JB, Husen A, Yasin J, Abamecha A, Wieser A, Abayneh M, 2025. Detections of antimicrobial resistance phenotypes and extended-spectrum beta-lactamase (ESBL)- producing Salmonella spps and Escherichia coli O157:H7 in raw vegetables and fruits from open markets in Jimma town, Ethiopia and evaluation of hygiene and handling practices of vendors. One Health Outlook 7:2.
Zhang J, Peng Z, Chen K, Zhan Z, Shen H, Feng S, Gou H, Qu X, Ziemann M, Layton DS, Wang X, Chen H, Wu B, Xu X, Liao M, 2023. Genomic characterization of Salmonella enterica serovar Weltevreden associated with human diarrhea. Microbiol Spectr 11:e0354222.
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