Session:

Typhoid Fever

Abstract No.:

18.001

Title:

Epidemiology of typhoid fever

Author(s):

L. Ochiai¹, M. I. Khan², S. Sahastrabuddhe³, T. Wierzba³; ¹International Vaccine Institute, Translational Research, Seoul/KR, ²International Vaccine Institute, Translational Research Division, Seoul/KR, ³International Vaccine Institute, Translational Research Division, Seoul, OTHERS - PLEASE SPECIFY/KR

Abstract:

Typhoid fever remains an important public health problem in the world especially in the impoverished population from developing countries. Globally, the disease is estimated to cause 220,000 deaths and 22 million illnesses per year, predominantly in children of school-age or younger. Typhoid fever is one of the most common etiological sources of bacteraemia in many developing countries. Within the countries, the disease burden is often heterogeneously distributed with the areas with poor hygiene and sanitation suffering the most.Studies from urban slums in India and Bangladesh reported very high incidence rate of typhoid fever in young children. A retrospective analysis of laboratory data from an urban hospital in Nepal identified typhoid infection to be one of the most leading causes of bacteraemia. Though these data are indication of high typhoid burden, utilizing different methods makes direct comparison impossible.The DOMI programme conducted a prospective, population-based surveillance in five Asian countries – China, India, Indonesia, Pakistan, and Vietnam – using standardized surveillance, clinical, and microbiological methods to comparatively assess the burden of typhoid fever in the region.The incidence rate of typhoid fever ranged from 15.3 cases per 100,000 persons 5 to 60 years old in China to 451.7 cases per 100,000 persons 2 to 15 years old in Pakistan. In the 5 to 15 year old age group, the incidence rate ranged from 24.2 cases per 100,000 persons in Vietnam to 493.5 cases per 100,000 persons in India.  For sites where surveillance was additionally undertaken in pre-school children (2 to 5 years of age), the incidence rate was found to be comparable to older children. Multidrug resistance (resistant to chloramphenicol, ampicillin and TMP-SMX) was observed from 85/127 S. Typhi isolates from Pakistan, 4/18 from Vietnam, and 8/113 from India.The finding highlights the considerable, but geographically heterogeneous, burden of typhoid fever in endemic areas of Asia, and underscores the importance of evidence on disease burden in making policy decisions about interventions to control this disease.