Abstract
.Typhoid conjugate vaccines represent a new tool for typhoid control. However, incidence data are needed to inform decisions about introduction. We sought to estimate typhoid and paratyphoid fever incidence in Vientiane, the capital and largest city of the Lao People’s Democratic Republic (Lao PDR). We did a representative cluster survey of health-seeking behavior for fever in Vientiane from January 15, 2019 through January 26, 2019. Multipliers derived from the survey were applied to data from Salmonella Typhi and Salmonella Paratyphi A bloodstream infection surveillance from Mahosot Hospital, Vientiane, for the period of January 1, 2015 through December 31, 2017, to estimate enteric fever incidence. A total of 336 households representing 1,740 persons were enrolled in the healthcare utilization survey, and multipliers were derived based on responses to questions about healthcare seeking in the event of febrile illness. Of 7,997 Vientiane residents receiving blood cultures over the 2-year surveillance period at Mahosot Hospital, we identified 16 (0.2%) with Salmonella Typhi and six (< 0.1%) with Salmonella Paratyphi A bloodstream infection. After applying multipliers, we estimated that the annual incidence of typhoid was 4.7 per 100,000 persons and paratyphoid was 0.5 per 100,000 persons. During the study period, the incidence of typhoid and paratyphoid fever was low in Vientiane. Ongoing surveillance is warranted to identify increases in future years. Similar studies elsewhere in the Lao PDR would be useful to understand the wider enteric fever situation in the country.
Highlights
Salmonella enterica serovars Typhi and ‘most often’ Paratyphi A cause typhoid and paratyphoid fever, collectively known as enteric fever
As with other countries in Southeast Asia,[4] Salmonella Typhi has been identified as a leading cause of community-onset bloodstream infection in the Lao People’s Democratic Republic (Lao PDR), in the capital of Vientiane[5] and in Luang Namtha in the northwest and Salavan in the south.[6]
We found that the incidence of typhoid fever, paratyphoid fever, and enteric fever overall in Vientiane in 2015–2017 was low
Summary
Salmonella enterica serovars Typhi and ‘most often’ Paratyphi A cause typhoid and paratyphoid fever, collectively known as enteric fever. Both pathogens are restricted to humans and are transmitted predominantly by water and food contaminated by human feces. In 2017, typhoid and paratyphoid fever were estimated to cause 10.9 and 3.4 million illnesses[1] and 116,800 and 19,100 deaths, respectively.[2] In Southeast Asia in 2017, enteric fever incidence was estimated to be 219.8 per 100,000 populations and associated with 877,200 disability-adjusted life-year lost.[3] As with other countries in Southeast Asia,[4] Salmonella Typhi has been identified as a leading cause of community-onset bloodstream infection in the Lao People’s Democratic Republic (Lao PDR), in the capital of Vientiane[5] and in Luang Namtha in the northwest and Salavan in the south.[6] multiple-drug resistance has been identified among Salmonella Typhi isolates in Lao PDR.[6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: The American journal of tropical medicine and hygiene
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
