Abstract

.The Tackling Typhoid supplement shows that typhoid fever continues to be a problem globally despite socioeconomic gains in certain settings. Morbidity remains high in many endemic countries, notably in sub-Saharan Africa and South Asia. In addition, antimicrobial resistance is a growing issue that poses a challenge for clinical management. The findings from this supplement revealed that outside of high-income countries, there were few reliable population-based estimates of typhoid and paratyphoid fever derived from surveillance systems. This indicates the need for monitoring systems that can also characterize the effectiveness of interventions, particularly in low- and middle-income settings. The country case studies indicated that gains in economic conditions, education, and environmental health may be associated with reductions in typhoid fever burden. Over the study period, the effect is mainly notable in countries with higher baseline levels of economic development, female literacy, and investments in public sanitation. High burden countries must continue to invest in strategies at the local level to address environmental factors such as access to safe drinking water and improved public sanitation that are known to interrupt transmission or diminish the risk of acquiring typhoid. Developing more effective vaccines and incorporating appropriate immunization strategies that target populations with the greatest risk could potentially alleviate disease burden.

Highlights

  • As several articles in this series have shown, despite much historical progress globally, typhoid fever remains a major problem in several parts of the world

  • As expected, that outside of highincome countries, there were very few reliable populationbased estimates of typhoid fever derived from robust surveillance systems

  • Reliable data on laboratory-confirmed cases of typhoid and paratyphoid fever with time trends were only available from a few centers or laboratories (Tables 2 and 3)

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Summary

Introduction

As several articles in this series have shown, despite much historical progress globally, typhoid fever remains a major problem in several parts of the world. These countries included Vietnam,15 Thailand,14 Chile,9 and South Africa.13 In other settings where typhoid fever trends were more uncertain, such as Pakistan,12 India,10 Bangladesh,8 and Nigeria,11 we obtained time trend information from large reference laboratories with standardized methods and documented denominators and relevant test volumes over time.

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