Abstract
During the coronavirus disease pandemic, we observed a 6.4-fold increase in typhoid intestinal perforation incidence in Antananarivo, Madagascar. Thirteen perforations occurred within 6 months (February 2020–July 2020), compared with 13 perforations during the previous 41 months (August 2016–January 2020). The increase may be attributable to delayed healthcare seeking during the pandemic.
Highlights
During the coronavirus disease pandemic, we observed a 6.4-fold increase in typhoid intestinal perforation incidence in Antananarivo, Madagascar
Since the beginning of the coronavirus disease (COVID-19) global pandemic in early 2020, SETA surveillance has found an alarming increase in surgically confirmed intestinal perforations cases in Madagascar
This increase, which does not correlate with an increase in blood culture–confirmed typhoid cases found through SETA surveillance, may insinuate the serious effects on healthcare-seeking behavior and healthcare quality that the COVID-19 pandemic has had in the country
Summary
During the coronavirus disease pandemic, we observed a 6.4-fold increase in typhoid intestinal perforation incidence in Antananarivo, Madagascar. In an effort to understand the health impacts of endemic typhoid, the Severe Typhoid Fever Surveillance in Africa Program (SETA) detects and records cases of surgically confirmed intestinal perforations, a relatively rare but severe complication of Salmonella enterica serovar Typhi infection [1]. Since the beginning of the coronavirus disease (COVID-19) global pandemic in early 2020, SETA surveillance has found an alarming increase in surgically confirmed intestinal perforations cases in Madagascar.
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