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Karen Schreiber,1 Matthias Kant,2 Claudia Pfleger,3 Henrik Boye Jensen,4 Ole Oesterberg,5 Anne Rieper Hald,5 Frederik K Nielsen,5 Sune Rubak6 1Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; 2Department of Neurology, Hospital of Southern Jutland, Soenderborg, Denmark; 3Department of Neurology, Aalborg University Hospital, Denmark; 4Department of Neurology, Kolding Hospital, Kolding, Denmark; 5Novartis Pharmaceutical, Copenhagen, Denmark; 6Department of Child and Adolescent Health, Aarhus University Hospital Skejby, Aarhus Denmark Purpose: Treatment adherence is a prerequisite for treatment success and therefore an important consideration to assure that therapeutic goals are achieved both from a patient point of view and for optimal health care resource utilization. Published data on treatment adherence with fingolimod (Gilenya®) are limited. Therefore, this study investigated treatment adherence in patients with relapsing-remitting multiple sclerosis (RRMS) treated with fingolimod in Denmark. Patients and methods: This was a 24-month, multicenter, open-label study, investigating treatment adherence, satisfaction, motivation, and health-related quality of life (QoL) in RRMS patients treated with fingolimod. In addition, the effect of a motivational interview support program on these measures was evaluated. Treatment adherence was assessed by pill count. Treatment satisfaction, motivation, and QoL were assessed by patient-reported outcomes (PROs). Results: A total of 195 patients were enrolled in the study. A very high treatment adherence was observed during the entire study with no statistically significant difference between study visits before (99%) and after (97%) the motivational interview. In accordance, a high level of treatment satisfaction was found in the Treatment Satisfaction Questionnaire for Medication 9, which was scored high throughout the study with the highest scores seen for the convenience domain (ranging from 94.51 to 95.78). Furthermore, additional PROs demonstrated a high health-related QoL, a self-determined form of motivation for taking medication, and a patient perception of an autonomy supportive approach provided by the health care provider, at all study visits. Conclusion: High levels of treatment adherence, satisfaction, motivation, and QoL were observed in Danish RRMS patients treated with fingolimod. As these positive measures were observed at all study visits and throughout the study, no effect of the motivational interview support program was found. Keywords: Gilenya®, multiple sclerosis, treatment adherence, motivational interview, quality of life, Treatment Satisfaction Questionnaire for Medication

This paper examines a PBL project module "Sustainable Urban Transformation" in an Urban Design master's education. The module combines urban design and hydrology engineering. Within the module, students are supported by lectures and study circles on various dimensions of sustainability, especially vis-a-vis climate change. However, they are left with the freedom to choose how they balance between design and engineering approaches when they give a physical form for sustainability in the site transformation projects with which they work through the semester. This paper discusses the development of their skills building on three Aristotelean concepts: techne (engineering), poiesis (aesthetic form-giving), and phronesis (making of ethical judgments). The last two concepts, the paper argues, are especially important when at issue is design education. Based on an analysis of the student projects in Fall 2022, the paper examines whether and how the students manage to find a balance between engineering skills, on the one hand, and aesthetic creativity and ethical judgement, on the other hand, in their project work.

Dinaol Belina,1,2 Tesfaye Gobena,3 Ameha Kebede,2 Meseret Chimdessa,2 Tine Hald4 1College of Veterinary Medicine, Haramaya University, Dire Dawa, Ethiopia; 2School of Biological Sciences and Biotechnology, Haramaya University, Dire Dawa, Ethiopia; 3College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4National Food Institute, Technical University of Denmark, Lyngby, DenmarkCorrespondence: Dinaol Belina, Email belina.dinaol@gmail.comBackground: Antimicrobial resistance (AMR) poses a significant global threat, particularly in low- and middle-income countries, such as Ethiopia, where surveillance is limited. This study aimed to predict and characterize the AMR profiles of diarrheagenic Escherichia coli (DEC) and nontyphoidal Salmonella (NTS) strains isolated from human, animal, food, and environmental samples using whole genome sequencing.Methods: A total of 57 NTS and 50 DEC isolates were sequenced on an Illumina NextSeq 550. The ResFinder and PointFinder tools were employed to identify antimicrobial resistance genes (ARGs) and point mutations. Salmonella serotypes were determined using SeqSero.Results: The analysis identified at least one ARG in every NTS sample and 78% of the DEC isolates, with 22 distinct ARGs in the NTS samples and 40 in the DEC samples. The most prevalent ARGs were aac(6′)-Iaa and aph(3′)-Ib, which predict aminoglycoside resistance in 100% of NTS and 54% of DEC isolates, respectively. Other commonly identified ARGs include sul 2, aph(6)-Id, blaTEM-1B, and tet(A), which confer resistance to folate inhibitors, aminoglycosides, β-lactams, and tetracycline. Some ARGs predicted phenotypic multidrug resistance in both DEC and NTS isolates. All identified β-lactam ARGs, except for blaTEM− 1D, conferred resistance to more than three antibiotics. Interestingly, blaCTX-M-15 was found to confer resistance to nine antibiotics, including third-generation cephalosporins, in 18% of DEC and 3.5% of NTS isolates. DEC isolates from children exhibited the highest ARG diversity. Notably, genes such as aph(3″)-Ib, aph(6)-Id, sul 2, and tet(A) were detected across all sample types, including water sources, although some ARGs were exclusive to specific sample types. Point mutations mediating AMR were detected in several genes, with mutations associated with nucleotide substitution being the most frequent.Conclusion: This genotypic AMR profiling revealed the presence of widespread drug-resistant NTS and DEC strains in Ethiopia. Robust and sustained AMR surveillance is essential for monitoring the emergence and spread of these resistant pathogens.Keywords: antimicrobial resistance, Ethiopia, foodborne pathogens, whole genome sequence

Aims: The aim of this study was to perform a systematic review and bias evaluation of the current literature to create an overview of risk factors for re-revision following revision total knee arthroplasty (rTKA). Methods: A systematic search of MEDLINE and Embase was completed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The studies were required to include a population of index rTKAs. Primary or secondary outcomes had to be re-revision. The association between preoperative factors and the effect on the risk for re-revision was also required to be reported by the studies. Results: The search yielded 4,847 studies, of which 15 were included. A majority of the studies were retrospective cohorts or registry studies. In total, 26 significant risk factors for re-revision were identified. Of these, the following risk factors were consistent across multiple studies: age at the time of index revision, male sex, index revision being partial revision, and index revision due to infection. Modifiable risk factors were opioid use, BMI > 40 kg/m2, and anaemia. History of one-stage revision due to infection was associated with the highest risk of re-revision. Conclusion: Overall, 26 risk factors have been associated with an increased risk of re-revision following rTKA. However, various levels of methodological bias were found in the studies. Future studies should ensure valid comparisons by including patients with identical indications and using clear definitions for accurate assessments. Cite this article: Bone Jt Open 2024;5(8):644–651.

Abstract Background Foodborne diseases (FBDs) represent a significant risk to public health, with nearly one in ten people falling ill every year globally. The large incidence of foodborne diseases in African low- and middle-income countries (LMIC) shows the immediate need for action, but there is still far to a robust and efficient outbreak detection system. The detection of outbreak heavily relies on clinical diagnosis, which are often delayed or ignored due to resource limitations and inadequate surveillance systems. Methods In total, 68 samples of non-typhoidal Salmonella isolates from human, animal and environmental sources collected between November 2021 and January 2023 were analyzed using sequencing methods to infer phylogenetic relationships between the samples. A source attribution model using a machine-learning logit-boost that predicted the likely source of infection for 20 cases of human salmonellosis was also run and compared with the results of the cluster detection. Results Three clusters of samples with close relation (SNP difference

Lightning protection is important for weather radars to prevent critical damage or outages, but this can have negative effects on data quality. The existing lightning protection of the German Meteorological Service (Deutscher Wetterdienst, DWD) polarimetric C-band weather radar network consists of four vertical poles with a maximum diameter of 10 cm. During radar operation, these rods cause local scattering in the near field of the antenna, resulting in negative impacts on radar products. One effect is the removal of significant transmission power from the main beam axis and its addition to other areas or the side lobes. This results in wrongly localised precipitation fields in a radial direction. The second effect is the loss of transmitted and received power, appearing as a decrease in system gain, and subsequently an underestimation of all power-based radar moments in the vicinity of the rods. The underestimation in radar reflectivity Z then leads to a negative bias of approximately 20 % in the actual rain rate if a Z–R relationship is applied. These detrimental effects on data quality led to the requirement of developing a new lightning protection concept. The new concept must minimise the effect on data quality but also provide sufficient protection from lightning strikes according to the existing regulations and requirements. Three possible lighting protection concepts are described in this paper: two using vertical rods of different diameters (16 and 40 mm) and one with horizontally placed rods outside the antenna aperture. Their possible influence on data quality is quantified through a dedicated measurement campaign by analysing resulting antenna patterns and precipitation sum products. Antenna patterns are analysed with respect to the side-lobe levels compared to antenna patterns without lightning protection and the original lightning protection. With the newly tested lightning rods, the apparent side-lobe levels are slightly increased compared to an antenna pattern taken without lightning protection but are within the accepted antenna specifications. Compared to the original lightning protection, a decrease of up to −15 dB in apparent side-lobe levels is found for all tested lightning protection options. Beam blockage is substantially reduced compared to the existing lightning protection, as shown by the evaluation of quantitative precipitation estimation (QPE) sums. These results and some structural considerations are a solid basis to recommend the installation of four rods with a maximum 40 mm diameter for all 17 radar systems of the DWD weather radar network.

Abstract Obesity impairs tissue insulin sensitivity and signaling, promoting type-2 diabetes. Although improving insulin signaling is key to reversing diabetes, the multi-organ mechanisms regulating this process are poorly defined. Here, we screen the secretome and receptome in Drosophila to identify the hormonal crosstalk affecting diet-induced insulin resistance and obesity. We discover a complex interplay between muscle, neuronal, and adipose tissues, mediated by Bone Morphogenetic Protein (BMP) signaling and the hormone Bursicon, that enhances insulin signaling and sugar tolerance. Muscle-derived BMP signaling, induced by sugar, governs neuronal Bursicon signaling. Bursicon, through its receptor Rickets, a Leucine-rich-repeat-containing G-protein coupled receptor (LGR), improves insulin secretion and insulin sensitivity in adipose tissue, mitigating hyperglycemia. In mouse adipocytes, loss of the Rickets ortholog LGR4 blunts insulin responses, showing an essential role of LGR4 in adipocyte insulin sensitivity. Our findings reveal a muscle-neuronal-fat-tissue axis driving metabolic adaptation to high-sugar conditions, identifying LGR4 as a critical mediator in this regulatory network.

Abstract Background Diarrheal diseases substantially affect public health impact in low- and middle-income countries (LMIC), particularly in Africa, where previous studies have indicated a lack of comprehensive data. With a growing number of primary studies on enteric infections in Africa, this study aimed to estimate the incidence and mortality of diarrheal pathogens across all ages in Africa in the year 2020. We also explored different methodological assumptions to allow comparison with other approaches. Methods Through a systematic review and meta-analysis of data from African LMICs, we estimated the etiology proportions for diarrheal diseases and deaths. We combined the etiology proportions with incidence data collected from a population survey in Africa from 2020 and mortality data from the Global Health Observatory of WHO. Results We estimated 1,008 billion diarrhea cases (95% UI 447 million-1,4 billion) and 515,031 diarrhea deaths (95% UI 248,983-1,007,641) in the African region in 2020. In children under five, enteroaggregative E. coli (EAEC) (44,073 cases per 100,000 people, 95% UI 18,818 − 60,922) and G. lamblia (36,116 cases per 100,000 people, 95% UI 15,245 − 49,961) were the leading causes of illness. Enteroinvasive E. coli (EIEC) (155 deaths per 100,000 people, 95% UI 106.5-252.9) and rotavirus (61.5 deaths per 100,000 people, 95% UI 42.3-100.3) were the primary causes of deaths. For children over five and adults, Salmonella spp. caused the largest number of diarrheal cases in the population of children ≥ 5 and adults (122,090 cases per 100,000 people, 95% UI 51,833 − 168,822), while rotavirus (16.4 deaths per 100,000 people, 95% UI 4.2–36.7) and enteroaggregative E. coli (EAEC) (14.6 deaths per 100,000 people, 95% UI 3.9–32.9) causing the most deaths. Geographically, the highest incidence of diarrhea was in Eastern Africa for children under five (114,389 cases per 100,000 people, 95% UI 34,771 − 172,884) and Central Africa for children over five and adults (117,820 cases per 100,000 people, 95% UI 75,111–157,584). Diarrheal mortality was highest in Western Africa for both children below five and above (children

Methodologies for source attribution (SA) of foodborne illnesses comprise a rapidly expanding suite of techniques for estimating the most important source or sources of human infection. Recently, the increasing availability of whole genome sequencing (WGS) data for a wide range of bacterial strains has led to the development of novel SA methods. These techniques utilize the unique features of bacterial genomes adapted to different host types and hence offer increased resolution of the outputs. Comparative studies of different SA techniques reliant on WGS data are currently lacking. Here, we critically assessed and compared the outputs of three SA methods: a supervised classification random forest machine learning algorithm (RandomForest), an Accessory genes-Based Source Attribution method (AB_SA), and a Bayesian frequency matching method (Bayesian). Each technique was applied to the WGS data of a panel of 902 reservoir host and human monophasic and biphasic Salmonella enterica subsp. enterica serovar Typhimurium isolates sampled in the British Isles (BI) and Denmark from 2012 to 2016. Additionally, for RandomForest and Bayesian, we explored whether utilization of accessory genome features as model inputs improved attribution accuracy of these methods over using the core genome derived features only. Results indicated that this was the case for RandomForest, but for Bayesian the overall attribution estimates varied little regardless of the inclusion or not of the accessory genome features. All three methods attributed the vast majority of human isolates to the Pigs primary source class, which was expected given the known high relative prevalence rates in pigs, and hence routes of infection into the human population, of monophasic and biphasic S. Typhimurium in the BI and Denmark. The accuracy of AB_SA was lower than of RandomForest when attributing the primary source classes to the 120 animal test set isolates with known primary sources. A major advantage of both AB_SA and Bayesian was a much faster execution time as compared to RandomForest. Overall, the SA method comparison presented in this study describes the strengths and weaknesses of each of the three methods applied to attributing potential monophasic and biphasic S. Typhimurium animal sources to human infections that could be valuable when deciding which SA methodology would be the most applicable to foodborne disease outbreak scenarios involving monophasic and biphasic S. Typhimurium.

Introduction Implementation science focuses on improving the dissemination, uptake and adoption of evidence into practice. Over the last decade, implementation science research has proliferated, particularly in healthcare and social science. The key synthesis of implementation frameworks conducted by Meyers and colleagues in 2012, and the resulting Quality Implementation Framework, has yet to be updated to incorporate this research. This protocol proposes an umbrella review of reviews (RORs) to synthesise the literature since 2012 on implementation science in the fields of healthcare and social science and provides recommendations for an updated Quality Implementation Framework.Methods and analysis This ROR will be conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four academic databases (PubMed, Scopus, PsycINFO and Web of Science) will be used to identify peer-reviewed meta-analyses, systematic reviews and scoping reviews published in the English language since January 2012 and report on the development, application or update of one or more implementation frameworks in healthcare or social science contexts. Multiple reviewers will be involved in the screening of articles and extraction of data, and the quality of reviews will be assessed using the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) 2. The outcome of interest is the content of implementation science frameworks reported in the included reviews. The content of these frameworks will be synthesised, aggregated and mapped to the four phases and 14 steps outlined in the original Quality Implementation Framework using both deductive and inductive analysis.Ethics and dissemination Ethics approval is not required as this ROR protocol and the resulting ROR do not involve primary data collection. The protocol as well as the ROR will be disseminated in peer-reviewed journals.PROSPERO registration number CRD42023475994.

Foodborne pathogens (FBPs) are transmitted principally through the consumption of contaminated food or drinking water and pose a remarkable public health risk, particularly in low-income countries. A cross-sectional study was conducted between November 2021 and January 2023 to estimate the prevalence, co-occurrence, and monthly patterns of FBPs in the physical exposures of children with diarrhea in Harar town and Kersa district, Ethiopia. Animal, food, and environmental samples were collected from direct or indirect contact sites of children with diarrhea. The isolation and identification of FBPs, including nontyphoidal Salmonella (NTS), diarrheagenic E. coli (DEC), and Shigella , was performed using selective and deferential culture media and a series of biochemical tests. Among the 438 analyzed samples, the overall prevalence of these pathogens was 18.3%, with 3.9% co-occurrence and 14.4% single pathogen occurrence rates. The highest prevalence was observed in wastewater (40.9%; AOR = 3.3; 95% CI: 1.1-10.1). The pathogen detection rate in food was 17.9% (AOR = 1.2; 95% CI: 0.4-3.6), with no significant difference between animal-sourced and other food categories. The occurrence rates of NTS, DEC, and Shigella in the meat samples were 13.9%, 5.4%, and 6.5%, respectively. Interestingly, DEC and Shigella were detected in cooked food. Moreover, Shigella was detected in drinking water (5%) and other water sources (10%). A significantly higher prevalence of FBPs was detected in poultry than in cattle and camel feces. This study revealed fluctuations in the monthly occurrence patterns of FBPs, with a peak of 37.1% during the dry season. In conclusion, the study revealed a high prevalence of FBPs, with no significant differences between rural and urban areas or food and water sources, highlighting the need for food safety measures in both settings. Further studies with larger sample sizes and advanced diagnostics are recommended to determine the relative contribution of each source.

Gremlin-1 has been implicated in liver fibrosis in metabolic dysfunction-associated steatohepatitis (MASH) via inhibition of bone morphogenetic protein (BMP) signalling and has thereby been identified as a potential therapeutic target. Using rat in vivo and human in vitro and ex vivo model systems of MASH fibrosis, we show that neutralisation of Gremlin-1 activity with monoclonal therapeutic antibodies does not reduce liver inflammation or liver fibrosis. Still, Gremlin-1 was upregulated in human and rat MASH fibrosis, but expression was restricted to a small subpopulation of COL3A1/THY1+ myofibroblasts. Lentiviral overexpression of Gremlin-1 in LX-2 cells and primary hepatic stellate cells led to changes in BMP-related gene expression, which did not translate to increased fibrogenesis. Furthermore, we show that Gremlin-1 binds to heparin with high affinity, which prevents Gremlin-1 from entering systemic circulation, prohibiting Gremlin-1-mediated organ crosstalk. Overall, our findings suggest a redundant role for Gremlin-1 in the pathogenesis of liver fibrosis, which is unamenable to therapeutic targeting.

ABSTRACTArginase-1 (Arg1) is expressed by regulatory myeloid cells in the tumor microenvironment (TME), where they play a pro-tumorigenic and T-cell suppressive role. Arg1-specific CD4+ and CD8+ memory T cells have been observed in both healthy individuals and cancer patients. However, while the function of anti-regulatory Arg1-specific CD4+ T cells has been characterized, our knowledge of CD8+ Arg1-specific T cells is only scarce. In the current study, we describe the immune-modulatory capabilities of CD8+ Arg1-specific T cells. We generated CD8+ Arg1-specific T cell clones to target Arg1-expressing myeloid cells. Our results demonstrate that these T cells recognize both malignant and nonmalignant regulatory myeloid cells in an Arg1-expression-dependent manner. Notably, Arg1-specific CD8+ T cells possess cytolytic effector capabilities. Immune modulatory vaccines (IMVs) represent a novel treatment modality for cancer. The activation of Arg1-specific CD8+ T cells through Arg1-based IMVs can contribute to the modulatory effects of this treatment strategy.

Purpose: The primary aim of our study was to identify the absolute incidence and implant survival of multiply revised knee arthroplasties based on nationwide register data. The secondary aim was to determine the change in the absolute incidence and implant survival of multiply revised knee arthroplasties Methods: We performed a retrospective observational study of primary knee arthroplasties using several nationwide Danish registers. All primary knee arthroplasties performed in Denmark from 1998 to 2021 were identified. From these primary arthroplasties, revision procedures were identified. Kaplan–Meier plots were used in survival analysis to estimate the likelihood of implant survival. Results: 161,384 primary knee arthroplasties and their revisions performed between 1998 and 2021 were identified; of 13,786 (8.5%) revisions there were 10,638 1st revisions, 2,148 2nd revisions, 624 3rd revisions, 223 4th revisions, and 153 procedures that had been revised more than 4 times. The 10-year revision-free survival of primary arthroplasties was 92.3% (95% confidence interval [CI] 92.2–92.5). First-time revisions had a 10-year revision-free survival of 75.9% (CI 74.9–76.9). The 10-year survival of second- and third-time revisions was 65.1% (CI 62.6–67.6) and 57.8% (CI 53.4–62.5), respectively. The 10-year implant survival probabilities of primary knee arthroplasties were 91.4% in 1998–2009 and 93.3% in 2010–2021 (difference 2.2%). The 10-year implant survival probabilities of 1st revisions were 77% in 1998–2009 and 75% in 2010–2021 (difference –2.4%). Conclusion: We found that 0.3% of all primary knee arthroplasties resulted in 3 or more revisions. The implant survival decreased for each consecutive revision, with almost half of the 3rd revisions being re-revised within 10 years. The 10-survival of the primary implant was higher in 2010–2021, and the 10-year survival of the 1st revision was higher in 1998–2009.

The corrosion behavior of alloy Ni 201 in molten sodium hydroxide (NaOH) at 600 °C was investigated at varying basicity levels of the molten NaOH. The ability for Ni 201 to form passivating oxides was investigated after immersion tests varying from 70 to 340 h under atmospheres of argon and argon with different partial pressure of water. Morphology and thicknesses of the corrosion products were characterized by Scanning Electron Microscopy (SEM) and crystallography of the corrosion products by X-ray Diffraction (XRD). Dynamic polarizations were made to investigate the effects of basicity and electrochemical potential.The results showed that Ni 201 corroded at a reduced rate in molten acidic NaOH compared to neutral NaOH due to the formation of NiO. The oxide scales formed on Ni 201 in acidic NaOH were shown to grow non-parabolically and did not result in full corrosion protection as the oxide scales showed crack development over time.

Vaccination before solid organ transplantation is recommended since post-transplantation immunosuppression is known to impair vaccine responses. However, little is known about post-transplantation seroprotection rates in organ transplant recipients vaccinated pre-transplantation. We aimed to investigate the proportion of transplant recipients vaccinated against hepatitis B virus (HBV) and invasive pneumococcal disease (IPD) pre-transplantation at the time of listing for transplantation with post-transplantation seroprotection. We included 136 solid organ transplant (SOT) recipients vaccinated at the time of listing for transplantation. We investigated post-transplantation antibody concentrations against HBV and IPD. Established antibody thresholds were used to define seroprotection. The proportions of SOT recipients with post-transplantation seroprotection were 27.9% (n = 38) and 42.6% (n = 58) against HBV and IPD, respectively. Compared to completing HBV vaccination pre-transplantation, completing post-transplantation vaccination (adjusted odds ratio (aOR): 7.8, 95% CI: 2.5–24.5, p < 0.001) and incomplete vaccination (aOR: 6.3, 95% CI: 1.2–32.6, p = 0.028) were associated with non-response against HBV, after adjustment for confounders. Importantly, patients with seroprotection at the time of listing had lower odds of non-response against HBV (aOR: 0.04, 95% CI: 0.0–0.1, p < 0.001) and IPD (aOR: 0.3, 95% CI: 0.1–0.7, p = 0.007) compared to those without seroprotection. SOT recipients vaccinated pre-transplantation had low post-transplantation seroprotection rates against HBV and IPD. However, SOT recipients with seroprotection at the time of listing had lower odds of non-response, suggesting early vaccination should be a priority.

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.