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

doi:10.1016/s2214-109x(22)00119-x

Cited by 44 publications

(59 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 lipopolysaccharide were lower among patients with S Paratyphi A infection than among patients with S Typhi infection, which we expected given that S Paratyphi A only shares the O12 antigen with S Typhi ( S Typhi has O9 and O12 antigens). Additionally, we observed elevated anti-lipopolysaccharide antibody responses among patients with invasive non-typhoidal Salmonella from Ghana .…”

Section: Discussionmentioning

confidence: 50%

“…During the enrolment visit, information on demographics, symptom history, and typhoid vaccination status were collected using a structured questionnaire; SEAP enrolment criteria and methods are detailed elsewhere. 17 For prospective cases, we collected plasma at SEAP enrolment and capillary blood collected on filter paper (ie, dried blood spot) at 28 days, 3 months, 6 months, 12 months, and 18 months post-enrolment. We also enrolled patients retrospectively and collected dried blood spots at enrolment and subsequent scheduled visits following the same follow up intervals.…”

Section: Methodsmentioning

confidence: 99%

“…Here, we model longitudinal immune responses to HlyE and lipopolysaccharide among patients with enteric fever confirmed by blood culture enrolled from two multi-year, 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%

“…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. 17 , 18 …”

Section: Introductionmentioning

confidence: 99%

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Estimating typhoid incidence from community-based serosurveys: a multicohort study

et al. 2022

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Section: Discussionmentioning

confidence: 50%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Estimating typhoid incidence from community-based serosurveys: a multicohort study

et al. 2022

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“…combining the likelihood for HlyE IgA and IgG for each age stratum using age-specific antibody dynamics. We selected age strata to match incidence estimates from blood culture enteric fever surveillance studies in other countries in sub-Saharan Africa and South Asia (14,15). This method incorporates heterogeneity in antibody responses and explicitly accounts for measurement error and biologic noise (12; Appendix reference 16).…”

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confidence: 99%

Seroincidence of Enteric Fever, Juba, South Sudan

Aiemjoy¹,

Rumunu²,

Hassen³

et al. 2022

Emerg. Infect. Dis.

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E nteric fever, caused by Salmonella enterica serovars Typhi and Paratyphi, causes substantial illness and death globally (1). However, estimating the population-level burden of infection is challenging. Blood culture, the standard for both diagnosis and surveillance, requires microbiological laboratory facilities that are not available in many low-and-middle-income countries. Challenges in accessing blood culture, along with an estimated diagnostics sensitivity of only 60% (2), contribute to chronic underdetection (3).Juba, the capital of South Sudan, experiences a high burden of enteric infections such as cholera and hepatitis E virus (4,5). Enteric fever is a frequently diagnosed etiology of acute fever, but few laboratories have blood culture capacity for confirmation. Consequentially, the population-level burden of enteric fever is unknown.Hemolysin E (HlyE), a pore-forming toxin, is a sensitive and specific serologic marker for diagnosing typhoidal Salmonella (6-10) and is not associated with typhoid carriage (11). New serologic and analytic tools enable measurement of population-level enteric fever incidence from cross-sectional serosurveys using HlyE IgG and IgA (12). We applied those tools to generate population-level enteric fever seroincidence estimates in Juba. The StudyWe used dried blood spots (DBS) collected for a SARS-CoV-2 serosurvey in Juba, South Sudan, enrolled during August 7-September 20, 2020; enrollment and sampling methods are described elsewhere (13). In brief, 2-stage cluster sampling was used to randomly select households from predefined enumeration units from 6 administrative divisions within and surrounding Juba; all persons >1 year of age and residing for >1 week within the sampled household were eligible to participate. Capillary blood was collected onto Whatman 903 Protein Saver cards (Sigma-Aldrich, https:// www.sigmaaldrich.com), air dried, and transported at ambient temperature to Massachusetts General Hospital (Boston, MA, USA), where they were stored at 4°C. We tested all banked samples collected from participants <25 years of age and a random sample of participants >25 years of age. Younger participants were prioritized because they matched the age distribution of typhoid case data used for the seroincidence estimation ( 12). The study protocol was approved by ethical review boards with the South Sudan Ministry of Health and Massachusetts General Hospital.We used kinetic ELISAs to quantify HlyE IgA and IgG levels in eluted DBS as described (7,11). To estimate seroincidence, we used the antibody dynamics from a longitudinal cohort of 1,420 blood culture-confirmed enteric fever cases (12). In brief, we created a likelihood function for observed crosssectional population antibody response data based on antibody dynamics after blood-culture confirmed infection. We generated joint incidence estimates by

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Treatment of enteric fever (typhoid and paratyphoid fever) with cephalosporins

Kuehn

Stoesser

Eyre

et al. 2022

Cochrane Database of Systematic Reviews

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Background Typhoid and paratyphoid (enteric fever) are febrile bacterial illnesses common in many low‐ and middle‐income countries. The World Health Organization (WHO) currently recommends treatment with azithromycin, ciprofloxacin, or ceftriaxone due to widespread resistance to older, first‐line antimicrobials. Resistance patterns vary in different locations and are changing over time. Fluoroquinolone resistance in South Asia often precludes the use of ciprofloxacin. Extensively drug‐resistant strains of enteric fever have emerged in Pakistan. In some areas of the world, susceptibility to old first‐line antimicrobials, such as chloramphenicol, has re‐appeared. A Cochrane Review of the use of fluoroquinolones and azithromycin in the treatment of enteric fever has previously been undertaken, but the use of cephalosporins has not been systematically investigated and the optimal choice of drug and duration of treatment are uncertain. Objectives To evaluate the effectiveness of cephalosporins for treating enteric fever in children and adults compared to other antimicrobials. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, the WHO ICTRP and ClinicalTrials.gov up to 24 November 2021. We also searched reference lists of included trials, contacted researchers working in the field, and contacted relevant organizations. Selection criteria We included randomized controlled trials (RCTs) in adults and children with enteric fever that compared a cephalosporin to another antimicrobial, a different cephalosporin, or a different treatment duration of the intervention cephalosporin. Enteric fever was diagnosed on the basis of blood culture, bone marrow culture, or molecular tests. Data collection and analysis We used standard Cochrane methods. Our primary outcomes were clinical failure, microbiological failure and relapse. Our secondary outcomes were time to defervescence, duration of hospital admission, convalescent faecal carriage, and adverse effects. We used the GRADE approach to assess certainty of evidence for each outcome. Main results We included 27 RCTs with 2231 total participants published between 1986 and 2016 across Africa, Asia, Europe, the Middle East and the Caribbean, with comparisons between cephalosporins and other antimicrobials used for the treatment of enteric fever in children and adults. The main comparisons are between antimicrobials in most common clinical use, namely cephalosporins compared to a fluoroquinolone and cephalosporins compared to azithromycin. Cephalosporin (cefixime) versus fluoroquinolones Clinical failure, microbiological failure and relapse may be increased in patients treated with cefixime compared to fluoroquinolones in three small trials published over 14 years ago: clinical failure (risk ratio (RR) 13.39...

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Incidence of typhoid and paratyphoid fever in Bangladesh, Nepal, and Pakistan: results of the Surveillance for Enteric Fever in Asia Project

Cited by 44 publications

References 26 publications

Estimating typhoid incidence from community-based serosurveys: a multicohort study

Estimating typhoid incidence from community-based serosurveys: a multicohort study

Seroincidence of Enteric Fever, Juba, South Sudan

Treatment of enteric fever (typhoid and paratyphoid fever) with cephalosporins

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