TY - JOUR
T1 - Incidence of typhoid bacteremia in infants and young children in Southern Coastal Pakistan
AU - Owais, Aatekah
AU - Sultana, Shazia
AU - Zaman, Umber
AU - Rizvi, Arjumand
AU - Zaidi, Anita K.M.
N1 - Funding Information:
Supported by the PneumoADIP Initiative at the Bloomberg School of Public Health, Johns Hopkins University, funded by the GAVI Alliance, and also supported by a training grant from the Fogarty International Center, National Institute of Health, USA (A.O., Grant ID43 TW0075 85 ).
PY - 2010/11
Y1 - 2010/11
N2 - Introduction: The burden of typhoid fever in preschool children is not well recognized. The purpose of this study was to estimate the incidence of typhoid bacteremia in Pakistani children <5 years of age, with a focus on children younger than 2 years of age. This will help to inform prevention policies in highly endemic countries. Methods: Household surveillance from February 1, 2007 to May 12, 2008, was carried out by community health workers in 2 low-income, coastal communities of Karachi. Workers referred each sick child <5 years old to the local clinic. Blood for culture was obtained from those who gave consent, and inoculated in BACTEC Peds Plus bottles (Becton Dickinson, Sparks, MD) and processed per manufacturer's guidelines. Results: Overall, 5570 children contributed 3949 observation years. Blood culture was obtained from 1165 cases, yielding 36 pathogens. Salmonella Typhi was isolated in 16 cases, Salmonella Paratyphi A in 2 cases, and Salmonella Paratyphi B in 1 case. The incidence of typhoid bacteremia in children <2 years of age was 443.1 (95% confidence interval, 193.8-876.5) per 100,000 child years. The overall incidence rate of typhoid for children <5 years was 405.1 (95% confidence interval, 239.8-643.9) per 100,000 child years. Conclusion: Typhoid is a common and significant cause of morbidity among young children in Pakistan, including children less than 2 years of age. Vaccines that provide protection to preschool children should be included in typhoid control efforts.
AB - Introduction: The burden of typhoid fever in preschool children is not well recognized. The purpose of this study was to estimate the incidence of typhoid bacteremia in Pakistani children <5 years of age, with a focus on children younger than 2 years of age. This will help to inform prevention policies in highly endemic countries. Methods: Household surveillance from February 1, 2007 to May 12, 2008, was carried out by community health workers in 2 low-income, coastal communities of Karachi. Workers referred each sick child <5 years old to the local clinic. Blood for culture was obtained from those who gave consent, and inoculated in BACTEC Peds Plus bottles (Becton Dickinson, Sparks, MD) and processed per manufacturer's guidelines. Results: Overall, 5570 children contributed 3949 observation years. Blood culture was obtained from 1165 cases, yielding 36 pathogens. Salmonella Typhi was isolated in 16 cases, Salmonella Paratyphi A in 2 cases, and Salmonella Paratyphi B in 1 case. The incidence of typhoid bacteremia in children <2 years of age was 443.1 (95% confidence interval, 193.8-876.5) per 100,000 child years. The overall incidence rate of typhoid for children <5 years was 405.1 (95% confidence interval, 239.8-643.9) per 100,000 child years. Conclusion: Typhoid is a common and significant cause of morbidity among young children in Pakistan, including children less than 2 years of age. Vaccines that provide protection to preschool children should be included in typhoid control efforts.
KW - Pakistan
KW - Typhoid
KW - incidence
KW - preschool children
UR - http://www.scopus.com/inward/record.url?scp=78149241589&partnerID=8YFLogxK
U2 - 10.1097/INF.0b013e3181e39f8b
DO - 10.1097/INF.0b013e3181e39f8b
M3 - Article
AN - SCOPUS:78149241589
SN - 0891-3668
VL - 29
SP - 1035
EP - 1039
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
IS - 11
ER -
