Incidence of Typhoid and Paratyphoid Fever in Bangladesh, Nepal, and Pakistan: Results of the Surveillance for Enteric Fever in Asia Project

Garrett, Denise O; Longley, Ashley T; Aiemjoy, Kristen; Qamar, Farah Naz; Saha, Samir K.; Yousafzai, Mohammad Tahir; Hemlock, Caitlin; Yu, Alexander T; Vaidya, Krista; Tamrakar, Dipesh; Saha, Shampa; Bogoch, Isaac I.; Bern, Caryn; Date, Kashmira; Saha, Senjuti; Islam, Mohammad Shahidul; Sayeed, Ishtiaque; Shakoor, Sadia; Dehraj, Irum F; Mehmood, Junaid; Sajib, Mohammad Saiful Islam; Islam, Maksuda; Thobani, Rozina; Hotwani, Aneeta; Rehman, Najeeb Ur; Irfan, Seema; Naga, Shiva Ram; Memon, Ashraf; Pradhan, Sailesh; Iqbal, Khalid; Shrestha, Rajeev; Rahman, Hafizur; Hasan, Mahmudul; Qazi, Saqib Hamid; Kazi, Abdul Momin; Saddal, Nasir Saleem; Syed, Jamal R; Hunzai, Mohammed J; Marks, Florian; Seidman, Jessica C.; Carter, Alice S.; Andrews, Jason R.; Luby, Stephen P.

doi:10.2139/ssrn.3866551

Cited by 7 publications

(16 citation statements)

References 26 publications

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“…In South Asia, 10-20% of enteric fever cases are caused by S. Paratyphi A (17). We found antibody responses for S. Typhi-LPS were lower among S. Paratyphi A cases than among S.…”

Section: Discussionmentioning

confidence: 62%

“…In South Asia, 10-20% of enteric fever cases are caused by S . Paratyphi A(17). We found antibody responses for S .…”

Section: Discussionmentioning

confidence: 99%

“…Patients were enrolled from five hospitals: Dhaka Shishu Hospital in Dhaka, Bangladesh; Kathmandu Medical College and Teaching Hospital (KMC) in Kathmandu and Dhulikhel Hospital, Kathmandu University Hospital (DH) in Kavre District, Nepal; and Aga Khan University Hospital (AKU) and Kharadar General Hospital (KGH) in Karachi, Pakistan; and a network of laboratory facilities in all three countries between 2016 and 2021. During the enrollment visit, information on demographics, symptom history and typhoid vaccination status were collected using a structured questionnaire; SEAP enrollment criteria and methods are detailed elsewhere (17). For prospective cases, we collected plasma at SEAP enrollment and capillary blood collected on filter paper (i.e., dried blood spot; DBS) at 28 days, 3, 6, 12, and 18 months post-enrollment.…”

Section: Study Populations and Enrollmentmentioning

confidence: 99%

“…Here, we model longitudinal immune responses to HlyE and LPS among blood culture-confirmed enteric fever patients enrolled from two multi-year, hospital-based, enteric fever surveillance studies: The Surveillance for Enteric Fever in Asia Project (SEAP) in Bangladesh, Nepal, and Pakistan, (17) and the Severe Typhoid in Africa (SETA) surveillance study in Ghana (18). We then use the longitudinal antibody dynamics to estimate typhoidal Salmonella seroincidence from cross-sectional population data and compare seroincidence rates to clinical incidence rates in the same catchment areas (17,18).…”

Section: Introductionmentioning

confidence: 99%

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Estimating typhoid incidence from community-based serosurveys: A multicohort study in Bangladesh, Nepal, Pakistan and Ghana

Aiemjoy

Seidman

Saha

et al. 2021

Preprint

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The incidence of enteric fever, an invasive bacterial infection caused by typhoidal Salmonellae, is largely unknown in regions lacking blood culture surveillance. New serologic markers have proven accurate in diagnosing enteric fever, but whether they could be used to reliably estimate population-level incidence is unknown. We collected longitudinal blood samples from blood culture-confirmed enteric fever cases enrolled from surveillance studies in Bangladesh, Nepal, Pakistan and Ghana and conducted cross-sectional sero-surveys in the catchment areas of each surveillance site. We used ELISAs to measure quantitative IgA and IgG antibody responses to Hemolysin E (HlyE) and S. Typhi lipopolysaccharide (LPS). We used Bayesian hierarchical models to fit two-phase power-function decay models to the longitudinal sero-responses among enteric fever cases and used the joint distributions of the peak antibody titers and decay rate to estimate population-level incidence rates from cross-sectional serosurveys. The longitudinal antibody kinetics for all antigen-isotypes were similar across countries and did not vary by clinical severity. The incidence of typhoidal Salmonella infection ranged between 41.2 per 100 person years (95% CI: 34.0-50.1) in Dhaka, Bangladesh to 5.8 (95% CI: 4.8-7.1) in Kavrepalanchok, Nepal and followed the same rank order as clinical incidence estimates. The approach described here has the potential to expand the geographic scope of typhoidal Salmonella surveillance and generate incidence estimates that are comparable across geographic regions and time.

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“…In South Asia, 10-20% of enteric fever cases are caused by S. Paratyphi A (17). We found antibody responses for S. Typhi-LPS were lower among S. Paratyphi A cases than among S.…”

Section: Discussionmentioning

confidence: 62%

“…In South Asia, 10-20% of enteric fever cases are caused by S . Paratyphi A(17). We found antibody responses for S .…”

Section: Discussionmentioning

confidence: 99%

Section: Study Populations and Enrollmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Estimating typhoid incidence from community-based serosurveys: A multicohort study in Bangladesh, Nepal, Pakistan and Ghana

Aiemjoy

Seidman

Saha

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…15 Lipopolysaccharide is a major component of the outer membrane of Gram-negative organisms and a potent inducer of innate immunity. 16 Here, we model longitudinal immune responses to HlyE and lipopolysaccharide among patients with enteric fever confirmed by blood culture enrolled from two multiyear, hospital-based, enteric fever surveillance studies: the Surveillance for Enteric Fever in Asia Project (SEAP) 17 in Bangladesh, Nepal, and Pakistan, and the Severe Typhoid in Africa (SETA) 18 surveillance study in Ghana. We then used the longitudinal antibody dynamics to estimate typhoidal Salmonella seroincidence from cross-sectional population data and compared seroincidence rates to clinical incidence rates in the same catchment areas.…”

Section: Introductionmentioning

confidence: 99%