Circulation of Salmonella spp. between humans, animals and the environment in animal-owning households in Malawi

Diverse salmonellae have the potential to cause disease and may be carried asymptomatically within the intestine of many vertebrate species. The relative contribution of human, animal, and environmental hosts to the transmission of Salmonella is unknown within and between households in low-income settings, especially where humans and animals may live in close contact and sanitary infrastructure is often inadequate. Between November 2018 and December 2019, we isolated Salmonella spp. from thirty households in urban and rural locations in Malawi, sampling at three time points from the stool of humans, animals, and their household environment. Using whole genome sequencing and fine-resolution bioinformatic and phylogenetic analyses we found evidence of sharing of Salmonella species and strains between humans, animals and the environment, both within and between households. The intricate web of interconnected salmonellae within this ecosystem underscores the importance of adopting a multi-faceted ‘One Health’ strategy when considering control of Salmonella in low-intensity agricultural systems.