Purpose: The objective of this review was to 1) identify existing peer-reviewed literature on the severity and incidence of LTHO associated with human salmonellosis, 2) qualitatively evaluate the strength of the evidence, and 3) identify potential data gaps.
Methods: LTHO were defined as symptoms that persist at least six months after infection, arise at least six months after infection or sequellae that are not expected to resolve. The online PubMed electronic database was searched using the indexed Medical Subject Headings to identify articles reporting primary research on LTHO from human case-control, case-series and cohort studies. Following a three-stage relevance screening, a full article review was conducted by a single reviewer to qualitatively assess relevance and quality and summarize findings.
Results: Of 121,020 identified articles, 76 were included in the review to date. Ten studies examined an entire population, four used disease registries, and a further 18 were outbreak specific. Several studies involved the same population over multiple time points. Follow-up ranged from none to 10+ years post-infection. 60 specific LTHO were identified and grouped into 14 health categories. The most commonly reported LTHO were reactive arthritis, cardiovascular sequellae, neurological sequellae, bone sequellae and GI sequellae.
Significance: Death, irritable bowel syndrome, reactive arthritis and neurological sequellae are LTHO very well supported by the literature. Other LTHOs have insufficient data to generate incidence estimates and further cohort studies are needed.