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Travel Medicine and Infectious Disease 2021Typhoid fever is a bacterial infection caused by the Gram-negative bacterium Salmonella enterica subspecies enterica serovar Typhi (S. Typhi), prevalent in many low- and... (Review)
Review
Typhoid fever is a bacterial infection caused by the Gram-negative bacterium Salmonella enterica subspecies enterica serovar Typhi (S. Typhi), prevalent in many low- and middle-income countries. In high-income territories, typhoid fever is predominantly travel-related, consequent to travel in typhoid-endemic regions; however, data show that the level of typhoid vaccination in travellers is low. Successful management of typhoid fever using antibiotics is becoming increasingly difficult due to drug resistance; emerging resistance has spread geographically due to factors such as increasing travel connectivity, affecting those in endemic regions and travellers alike. This review provides an overview of: the epidemiology and diagnosis of typhoid fever; the emergence of drug-resistant typhoid strains in the endemic setting; drug resistance observed in travellers; vaccines currently available to prevent typhoid fever; vaccine recommendations for people living in typhoid-endemic regions; strategies for the introduction of typhoid vaccines and stakeholders in vaccination programmes; and travel recommendations for a selection of destinations with a medium or high incidence of typhoid fever.
Topics: Anti-Bacterial Agents; Drug Resistance, Microbial; Humans; Salmonella typhi; Travel; Travel-Related Illness; Typhoid Fever; Vaccination
PubMed: 33301931
DOI: 10.1016/j.tmaid.2020.101946 -
Clinical Infectious Diseases : An... Feb 2019Salmonella enterica subspecies enterica serovar Typhi (Salmonella Typhi) is the cause of typhoid fever and a human host-restricted organism. Our understanding of the...
Salmonella enterica subspecies enterica serovar Typhi (Salmonella Typhi) is the cause of typhoid fever and a human host-restricted organism. Our understanding of the global burden of typhoid fever has improved in recent decades, with both an increase in the number and geographic representation of high-quality typhoid fever incidence studies, and greater sophistication of modeling approaches. The 2017 World Health Organization Strategic Advisory Group of Experts on Immunization recommendation for the introduction of typhoid conjugate vaccines for infants and children aged >6 months in typhoid-endemic countries is likely to require further improvements in our understanding of typhoid burden at the global and national levels. Furthermore, the recognition of the critical and synergistic role of water and sanitation improvements in concert with vaccine introduction emphasize the importance of improving our understanding of the sources, patterns, and modes of transmission of Salmonella Typhi in diverse settings.
Topics: Child, Preschool; Disease Reservoirs; Global Health; Humans; Incidence; Infant; Practice Guidelines as Topic; Typhoid Fever; Typhoid-Paratyphoid Vaccines
PubMed: 30767000
DOI: 10.1093/cid/ciy846 -
The New England Journal of Medicine Nov 2002
Review
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Drug Resistance, Bacterial; Drug Resistance, Multiple; Endemic Diseases; Escherichia coli; Fluoroquinolones; Genome, Bacterial; Humans; Salmonella typhi; Typhoid Fever; Typhoid-Paratyphoid Vaccines
PubMed: 12456854
DOI: 10.1056/NEJMra020201 -
The American Journal of Tropical... Sep 2018The Tackling Typhoid supplement shows that typhoid fever continues to be a problem globally despite socioeconomic gains in certain settings. Morbidity remains high in... (Review)
Review
The Tackling Typhoid supplement shows that typhoid fever continues to be a problem globally despite socioeconomic gains in certain settings. Morbidity remains high in many endemic countries, notably in sub-Saharan Africa and South Asia. In addition, antimicrobial resistance is a growing issue that poses a challenge for clinical management. The findings from this supplement revealed that outside of high-income countries, there were few reliable population-based estimates of typhoid and paratyphoid fever derived from surveillance systems. This indicates the need for monitoring systems that can also characterize the effectiveness of interventions, particularly in low- and middle-income settings. The country case studies indicated that gains in economic conditions, education, and environmental health may be associated with reductions in typhoid fever burden. Over the study period, the effect is mainly notable in countries with higher baseline levels of economic development, female literacy, and investments in public sanitation. High burden countries must continue to invest in strategies at the local level to address environmental factors such as access to safe drinking water and improved public sanitation that are known to interrupt transmission or diminish the risk of acquiring typhoid. Developing more effective vaccines and incorporating appropriate immunization strategies that target populations with the greatest risk could potentially alleviate disease burden.
Topics: Africa South of the Sahara; Anti-Bacterial Agents; Asia, Southeastern; Asia, Western; Chile; Food Safety; Global Health; Humans; Paratyphoid Fever; Public Health; Sanitation; Typhoid Fever
PubMed: 30047361
DOI: 10.4269/ajtmh.18-0111 -
International Journal of Infectious... Jun 2022Salmonella enterica serotype Typhi (S Typhi) causes typhoid fever and is responsible for an estimated 9 million cases and 110,000 deaths globally per annum. Typhoid...
Salmonella enterica serotype Typhi (S Typhi) causes typhoid fever and is responsible for an estimated 9 million cases and 110,000 deaths globally per annum. Typhoid fever is endemic in areas where water, sanitation, and hygiene (WaSH) infrastructure is poor. Serious complications develop in approximately 10%-15% of patients if left untreated, and this is driven by inadequate diagnostic methods and the high burden of antibiotic-resistant strains, complicating clinical management and ultimately prognosis. Asymptomatic chronic carriers, in addition to acutely infected patients, contribute to continued transmission through the shedding of the organism in the feces. The high morbidity and mortality of typhoid fever in low- and middle-income countries reinforce the need for an integrated control approach, which may ultimately lead to elimination of the disease in the 21 century. Here we discuss the challenges faced in pursuit of typhoid fever elimination.
Topics: Anti-Bacterial Agents; Humans; Salmonella; Salmonella typhi; Typhoid Fever
PubMed: 35338009
DOI: 10.1016/j.ijid.2022.03.036 -
Indian Pediatrics Jun 2019Typhoid fever, an infection with potentially life threatening complications, is responsible for 11 to 21 million illness episodes and 145,000 to 161,000 deaths each year... (Review)
Review
Typhoid fever, an infection with potentially life threatening complications, is responsible for 11 to 21 million illness episodes and 145,000 to 161,000 deaths each year globally. India is a high burden country and also faces the challenge of antimicrobial resistance, which further narrows treatment options. This review analyzes the need for typhoid vaccination in India, and appraises the evidence on efficacy, immunogenicity and cost-effectiveness of currently available typhoid vaccines. In 2018, WHO prequalified the first typhoid conjugate vaccine Vi-TT and recommended it for children aged 6-23 months, along with measles vaccine at 9 or 15 months of age through the expanded programme on immunization. With the high endemicity of typhoid in India and the proven cost-effectiveness of the conjugate vaccine, a roll-out of typhoid vaccine should be considered at the earliest.
Topics: Child; Child, Preschool; Cost-Benefit Analysis; Health Care Costs; Health Services Accessibility; Humans; Immunization Programs; Immunization Schedule; India; Infant; Needs Assessment; Typhoid Fever; Typhoid-Paratyphoid Vaccines
PubMed: 31278221
DOI: No ID Found -
Clinical Infectious Diseases : An... Oct 2019Making a Difference? brings together medical humanities and sciences experts to analyze how historical and new data on typhoid control can be brought to bear on the...
Making a Difference? brings together medical humanities and sciences experts to analyze how historical and new data on typhoid control can be brought to bear on the current context of typhoid conjugate vaccine rollouts and extensively drug-resistant typhoid.
Topics: Communicable Disease Control; Congresses as Topic; History, 19th Century; History, 20th Century; Humans; Hygiene; Poverty; Sanitation; Typhoid Fever; Typhoid-Paratyphoid Vaccines; Vaccination
PubMed: 31612936
DOI: 10.1093/cid/ciz551 -
Epidemiology and Infection May 2022Typhoid fever is a major cause of illness and mortality in low- and middle-income settings. We investigated the association of typhoid fever and rainfall in Blantyre,...
Typhoid fever is a major cause of illness and mortality in low- and middle-income settings. We investigated the association of typhoid fever and rainfall in Blantyre, Malawi, where multi-drug-resistant typhoid has been transmitting since 2011. Peak rainfall preceded the peak in typhoid fever by approximately 15 weeks [95% confidence interval (CI) 13.3, 17.7], indicating no direct biological link. A quasi-Poisson generalised linear modelling framework was used to explore the relationship between rainfall and typhoid incidence at biologically plausible lags of 1-4 weeks. We found a protective effect of rainfall anomalies on typhoid fever, at a two-week lag ( 0.006), where a 10 mm lower-than-expected rainfall anomaly was associated with up to a 16% reduction in cases (95% CI 7.6, 26.5). Extreme flooding events may cleanse the environment of Typhi, while unusually low rainfall may reduce exposure from sewage overflow. These results add to evidence that rainfall anomalies may play a role in the transmission of enteric pathogens, and can help direct future water and sanitation intervention strategies for the control of typhoid fever.
Topics: Drug Resistance, Multiple; Humans; Incidence; Malawi; Poisson Distribution; Poverty; Rain; Sanitation; Social Class; Typhoid Fever
PubMed: 35535751
DOI: 10.1017/S0950268822000759 -
The Journal of Infectious Diseases Dec 2021The disease burden of typhoid fever remains high in endemic areas in Asia and Africa, especially in children. Recent clinical trials conducted by the Typhoid Vaccine...
The disease burden of typhoid fever remains high in endemic areas in Asia and Africa, especially in children. Recent clinical trials conducted by the Typhoid Vaccine Acceleration Consortium show typhoid conjugate vaccine (TCV) to be safe, immunogenic, and efficacious at preventing blood culture-confirmed typhoid fever in African and Asian children. Pakistan, Liberia, and Zimbabwe recently introduced TCV through campaigns and routine childhood immunizations, providing protection for this vulnerable population. It is essential to continue this momentum while simultaneously filling data gaps-including typhoid complications-to inform decision-making on TCV introduction. A multidisciplinary approach including surveillance, water, sanitation, and hygiene investments, and large-scale TCV introduction is needed to decrease the burden and mortality of typhoid fever.
Topics: Child; Humans; Immunization Programs; Immunogenicity, Vaccine; Pakistan; Public Health; Salmonella typhi; Typhoid Fever; Typhoid-Paratyphoid Vaccines; Vaccine Efficacy; Vaccines, Conjugate; Zimbabwe
PubMed: 34528085
DOI: 10.1093/infdis/jiab449 -
The Journal of Infection Dec 2020Updated estimates of the prevalence of complications and case fatality ratio (CFR) among typhoid fever patients are needed to understand disease burden. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Updated estimates of the prevalence of complications and case fatality ratio (CFR) among typhoid fever patients are needed to understand disease burden.
METHODS
Articles published in PubMed and Web of Science from 1 January 1980 through 29 January 2020 were systematically reviewed for hospital or community-based non-surgical studies that used cultures of normally sterile sites, and hospital surgical studies of typhoid intestinal perforation (TIP) with intra- or post-operative findings suggestive of typhoid. Prevalence of 21 pre-selected recognized complications of typhoid fever, crude and median (interquartile range) CFR, and pooled CFR estimates using a random effects meta-analysis were calculated.
RESULTS
Of 113 study sites, 106 (93.8%) were located in Asia and Africa, and 84 (74.3%) were non-surgical. Among non-surgical studies, 70 (83.3%) were hospital-based. Of 10,355 confirmed typhoid patients, 2,719 (26.3%) had complications. The pooled CFR estimate among non-surgical patients was 0.9% for the Asia region and 5.4% for the Africa region. Delay in care was significantly correlated with increased CFR in Asia (r = 0.84; p<0.01). Among surgical studies, the median CFR of TIP was 15.5% (6.7-24.1%) per study.
CONCLUSIONS
Our findings identify considerable typhoid-associated illness and death that could be averted with prevention measures, including typhoid conjugate vaccine introduction.
Topics: Africa; Asia; Humans; Intestinal Perforation; Prevalence; Typhoid Fever
PubMed: 33144193
DOI: 10.1016/j.jinf.2020.10.030