TY - JOUR
T1 - A study of typhoid fever in five Asian countries
T2 - Disease burden and implications for controls
AU - Ochiai, R. Leon
AU - Acosta, Camilo J.
AU - Danovaro-Holliday, M. Carolina
AU - Baiqing, Dong
AU - Bhattacharya, Sujit K.
AU - Agtini, Magdarina D.
AU - Bhutta, Zulfiqar A.
AU - Canh, Do Gia
AU - Ali, Mohammad
AU - Shin, Seonghye
AU - Wain, John
AU - Page, Anne Laure
AU - Albert, M. John
AU - Farrar, Jeremy
AU - Abu-Elyazeed, Remon
AU - Pang, Tikki
AU - Galindo, Claudia M.
AU - Von Seidlein, Lorenz
AU - Clemens, John D.
AU - Jin, Yang
AU - Dabin, Liang
AU - Mingliu, Wang
AU - Honghui, Yang
AU - Sur, Dipika
AU - Manna, Byomkesh
AU - Dutta, Shanta
AU - Nizami, S. Qamaruddin
AU - Khan, Mohammad Imran
AU - Hassan, Rumina
AU - Dang, Duc Anh
AU - Vu, Din Thiem
AU - Nguyen, S. H.
AU - Hoang, P. T.
AU - Simanjuntak, Cyrus
AU - Punjabi, Narain
AU - Deen, Jacqueline L.
AU - Xu, Zhi Yi
AU - Park, Jin Kyung
AU - Jodar, Luis
PY - 2008/4
Y1 - 2008/4
N2 - Objective: To inform policy-makers about introduction of preventive interventions against typhoid, including vaccination. Methods: A population-based prospective surveillance design was used. Study sites where typhoid was considered a problem by local authorities were established in China, India, Indonesia, Pakistan and Viet Nam. Standardized clinical, laboratory, and surveillance methods were used to investigate cases of fever of ≥ 3 days' duration for a one-year period. A total of 441 435 persons were under surveillance, 159 856 of whom were aged 5-15 years. Findings: A total of 21 874 episodes of fever were detected. Salmonella typhi was isolated from 475 (2%) blood cultures, 57% (273/475) of which were from 5-15 year-olds. The annual typhoid incidence (per 100 000 person years) among this age group varied from 24.2 and 29.3 in sites in Viet Nam and China, respectively, to 180.3 in the site in Indonesia; and to 412.9 and 493.5 in sites in Pakistan and India, respectively. Altogether, 23% (96/413) of isolates were multidrug resistant (chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole). Conclusion: The incidence of typhoid varied substantially between sites, being high in India and Pakistan, intermediate in Indonesia, and low in China and Viet Nam. These findings highlight the considerable, but geographically heterogeneous, burden of typhoid fever in endemic areas of Asia, and underscore the importance of evidence on disease burden in making policy decisions about interventions to control this disease.
AB - Objective: To inform policy-makers about introduction of preventive interventions against typhoid, including vaccination. Methods: A population-based prospective surveillance design was used. Study sites where typhoid was considered a problem by local authorities were established in China, India, Indonesia, Pakistan and Viet Nam. Standardized clinical, laboratory, and surveillance methods were used to investigate cases of fever of ≥ 3 days' duration for a one-year period. A total of 441 435 persons were under surveillance, 159 856 of whom were aged 5-15 years. Findings: A total of 21 874 episodes of fever were detected. Salmonella typhi was isolated from 475 (2%) blood cultures, 57% (273/475) of which were from 5-15 year-olds. The annual typhoid incidence (per 100 000 person years) among this age group varied from 24.2 and 29.3 in sites in Viet Nam and China, respectively, to 180.3 in the site in Indonesia; and to 412.9 and 493.5 in sites in Pakistan and India, respectively. Altogether, 23% (96/413) of isolates were multidrug resistant (chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole). Conclusion: The incidence of typhoid varied substantially between sites, being high in India and Pakistan, intermediate in Indonesia, and low in China and Viet Nam. These findings highlight the considerable, but geographically heterogeneous, burden of typhoid fever in endemic areas of Asia, and underscore the importance of evidence on disease burden in making policy decisions about interventions to control this disease.
UR - http://www.scopus.com/inward/record.url?scp=42049095893&partnerID=8YFLogxK
U2 - 10.2471/BLT.06.039818
DO - 10.2471/BLT.06.039818
M3 - Article
C2 - 18438514
AN - SCOPUS:42049095893
SN - 0042-9686
VL - 86
SP - 260
EP - 268
JO - Bulletin of the World Health Organization
JF - Bulletin of the World Health Organization
IS - 4
ER -
