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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Burden of typhoid fever in low-income and middle-income countries: A systematic, literature-based update with risk-factor adjustment
The Lancet Global Health, Volume 2, No. 10, Year 2014
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Description
Background: No access to safe water is an important risk factor for typhoid fever, yet risk-level heterogeneity is unaccounted for in previous global burden estimates. Since WHO has recommended risk-based use of typhoid polysaccharide vaccine, we revisited the burden of typhoid fever in low-income and middle-income countries (LMICs) after adjusting for water-related risk. Methods: We estimated the typhoid disease burden from studies done in LMICs based on blood-culture-confirmed incidence rates applied to the 2010 population, after correcting for operational issues related to surveillance, limitations of diagnostic tests, and water-related risk. We derived incidence estimates, correction factors, and mortality estimates from systematic literature reviews. We did scenario analyses for risk factors, diagnostic sensitivity, and case fatality rates, accounting for the uncertainty in these estimates and we compared them with previous disease burden estimates. Findings: The estimated number of typhoid fever cases in LMICs in 2010 after adjusting for water-related risk was 11·9 million (95% CI 9·9-14·7) cases with 129 000 (75 000-208 000) deaths. By comparison, the estimated risk-unadjusted burden was 20·6 million (17·5-24·2) cases and 223 000 (131 000-344 000) deaths. Scenario analyses indicated that the risk-factor adjustment and updated diagnostic test correction factor derived from systematic literature reviews were the drivers of differences between the current estimate and past estimates. Interpretation: The risk-adjusted typhoid fever burden estimate was more conservative than previous estimates. However, by distinguishing the risk differences, it will allow assessment of the effect at the population level and will facilitate cost-effectiveness calculations for risk-based vaccination strategies for future typhoid conjugate vaccine. Funding: Bill and Melinda Gates Foundation. © 2014 Mogasale et al. Open Access article distributed under the terms of CC BY-NC-SA.
Authors & Co-Authors
Mogasale, Vittal
South Korea, Seoul
International Vaccine Institute, Seoul
Ochiai, R. Leon
South Korea, Seoul
International Vaccine Institute, Seoul
Ramani, Enusa
South Korea, Seoul
International Vaccine Institute, Seoul
Park, Jinkyung Kyoung
South Korea, Seoul
International Vaccine Institute, Seoul
Wierzba, Thomas F.
South Korea, Seoul
International Vaccine Institute, Seoul
Statistics
Citations: 369
Authors: 5
Affiliations: 1
Identifiers
Doi:
10.1016/S2214-109X(14)70301-8
ISSN:
2214109X
Research Areas
Environmental
Genetics And Genomics
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study