Burden of typhoid and paratyphoid fever in a densely populated urban community, Dhaka, Bangladesh

Aliya Naheed, Pavani K. Ram, W Abdullah Brooks, M. Anowar Hossain, Michele B. Parsons, Kaisar Ali Talukder, Eric Mintz, Stephen Luby, Robert F. Breiman

Research output: Contribution to journalArticle

Abstract

Background: We conducted blood culture surveillance to estimate the incidence of typhoid and paratyphoid fever among urban slum residents in Dhaka, Bangladesh. Methods: Between January 7, 2003 and January 6, 2004, participants were visited weekly to detect febrile illnesses. Blood cultures were obtained at the clinic from patients with fever (≥38 °C). Salmonella isolates were assayed for antimicrobial susceptibility. Results: Forty Salmonella Typhi and eight Salmonella Paratyphi A were isolated from 961 blood cultures. The incidence of typhoid fever was 2.0 episodes/1000 person-years, with a higher incidence in children aged <5 years (10.5/1000 person-years) than in older persons (0.9/1000 person-years) (relative risk. = 12, 95% confidence interval (CI) 6.3-22.6). The incidence of paratyphoid fever was 0.4/1000 person-years without variation by age group. Sixteen S. Typhi isolates were multidrug-resistant (MDR). All S. Paratyphi isolates were pan-susceptible. The duration of fever among patients with an MDR S. Typhi infection was longer than among patients with non-MDR S. Typhi (16 ± 8 vs. 11 ± 4 days, p= 0.02) and S. Paratyphi (10 ± 2 days, p= 0.04) infections. Conclusions: Typhoid fever is more common than paratyphoid fever in the urban Bangladeshi slum; children <5 years old have the highest incidence. Multidrug resistance is common in S. Typhi isolates and is associated with prolonged illness. Strategies for typhoid fever prevention in children aged <5 years in Bangladesh, including immunization, are needed.

Original languageEnglish (US)
JournalInternational Journal of Infectious Diseases
Volume14
Issue numberSUPPL. 3
DOIs
StatePublished - Sep 2010
Externally publishedYes

Fingerprint

Paratyphoid Fever
Salmonella typhi
Bangladesh
Typhoid Fever
Salmonella paratyphi A
Incidence
Poverty Areas
Fever
Salmonella Infections
Multiple Drug Resistance
Salmonella
Immunization
Age Groups
Confidence Intervals
Infection
Blood Culture

Keywords

  • Bangladesh
  • Burden
  • Typhoid and paratyphoid fever
  • Urban

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Burden of typhoid and paratyphoid fever in a densely populated urban community, Dhaka, Bangladesh. / Naheed, Aliya; Ram, Pavani K.; Brooks, W Abdullah; Hossain, M. Anowar; Parsons, Michele B.; Talukder, Kaisar Ali; Mintz, Eric; Luby, Stephen; Breiman, Robert F.

In: International Journal of Infectious Diseases, Vol. 14, No. SUPPL. 3, 09.2010.

Research output: Contribution to journalArticle

Naheed, Aliya ; Ram, Pavani K. ; Brooks, W Abdullah ; Hossain, M. Anowar ; Parsons, Michele B. ; Talukder, Kaisar Ali ; Mintz, Eric ; Luby, Stephen ; Breiman, Robert F. / Burden of typhoid and paratyphoid fever in a densely populated urban community, Dhaka, Bangladesh. In: International Journal of Infectious Diseases. 2010 ; Vol. 14, No. SUPPL. 3.
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abstract = "Background: We conducted blood culture surveillance to estimate the incidence of typhoid and paratyphoid fever among urban slum residents in Dhaka, Bangladesh. Methods: Between January 7, 2003 and January 6, 2004, participants were visited weekly to detect febrile illnesses. Blood cultures were obtained at the clinic from patients with fever (≥38 °C). Salmonella isolates were assayed for antimicrobial susceptibility. Results: Forty Salmonella Typhi and eight Salmonella Paratyphi A were isolated from 961 blood cultures. The incidence of typhoid fever was 2.0 episodes/1000 person-years, with a higher incidence in children aged <5 years (10.5/1000 person-years) than in older persons (0.9/1000 person-years) (relative risk. = 12, 95{\%} confidence interval (CI) 6.3-22.6). The incidence of paratyphoid fever was 0.4/1000 person-years without variation by age group. Sixteen S. Typhi isolates were multidrug-resistant (MDR). All S. Paratyphi isolates were pan-susceptible. The duration of fever among patients with an MDR S. Typhi infection was longer than among patients with non-MDR S. Typhi (16 ± 8 vs. 11 ± 4 days, p= 0.02) and S. Paratyphi (10 ± 2 days, p= 0.04) infections. Conclusions: Typhoid fever is more common than paratyphoid fever in the urban Bangladeshi slum; children <5 years old have the highest incidence. Multidrug resistance is common in S. Typhi isolates and is associated with prolonged illness. Strategies for typhoid fever prevention in children aged <5 years in Bangladesh, including immunization, are needed.",
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T1 - Burden of typhoid and paratyphoid fever in a densely populated urban community, Dhaka, Bangladesh

AU - Naheed, Aliya

AU - Ram, Pavani K.

AU - Brooks, W Abdullah

AU - Hossain, M. Anowar

AU - Parsons, Michele B.

AU - Talukder, Kaisar Ali

AU - Mintz, Eric

AU - Luby, Stephen

AU - Breiman, Robert F.

PY - 2010/9

Y1 - 2010/9

N2 - Background: We conducted blood culture surveillance to estimate the incidence of typhoid and paratyphoid fever among urban slum residents in Dhaka, Bangladesh. Methods: Between January 7, 2003 and January 6, 2004, participants were visited weekly to detect febrile illnesses. Blood cultures were obtained at the clinic from patients with fever (≥38 °C). Salmonella isolates were assayed for antimicrobial susceptibility. Results: Forty Salmonella Typhi and eight Salmonella Paratyphi A were isolated from 961 blood cultures. The incidence of typhoid fever was 2.0 episodes/1000 person-years, with a higher incidence in children aged <5 years (10.5/1000 person-years) than in older persons (0.9/1000 person-years) (relative risk. = 12, 95% confidence interval (CI) 6.3-22.6). The incidence of paratyphoid fever was 0.4/1000 person-years without variation by age group. Sixteen S. Typhi isolates were multidrug-resistant (MDR). All S. Paratyphi isolates were pan-susceptible. The duration of fever among patients with an MDR S. Typhi infection was longer than among patients with non-MDR S. Typhi (16 ± 8 vs. 11 ± 4 days, p= 0.02) and S. Paratyphi (10 ± 2 days, p= 0.04) infections. Conclusions: Typhoid fever is more common than paratyphoid fever in the urban Bangladeshi slum; children <5 years old have the highest incidence. Multidrug resistance is common in S. Typhi isolates and is associated with prolonged illness. Strategies for typhoid fever prevention in children aged <5 years in Bangladesh, including immunization, are needed.

AB - Background: We conducted blood culture surveillance to estimate the incidence of typhoid and paratyphoid fever among urban slum residents in Dhaka, Bangladesh. Methods: Between January 7, 2003 and January 6, 2004, participants were visited weekly to detect febrile illnesses. Blood cultures were obtained at the clinic from patients with fever (≥38 °C). Salmonella isolates were assayed for antimicrobial susceptibility. Results: Forty Salmonella Typhi and eight Salmonella Paratyphi A were isolated from 961 blood cultures. The incidence of typhoid fever was 2.0 episodes/1000 person-years, with a higher incidence in children aged <5 years (10.5/1000 person-years) than in older persons (0.9/1000 person-years) (relative risk. = 12, 95% confidence interval (CI) 6.3-22.6). The incidence of paratyphoid fever was 0.4/1000 person-years without variation by age group. Sixteen S. Typhi isolates were multidrug-resistant (MDR). All S. Paratyphi isolates were pan-susceptible. The duration of fever among patients with an MDR S. Typhi infection was longer than among patients with non-MDR S. Typhi (16 ± 8 vs. 11 ± 4 days, p= 0.02) and S. Paratyphi (10 ± 2 days, p= 0.04) infections. Conclusions: Typhoid fever is more common than paratyphoid fever in the urban Bangladeshi slum; children <5 years old have the highest incidence. Multidrug resistance is common in S. Typhi isolates and is associated with prolonged illness. Strategies for typhoid fever prevention in children aged <5 years in Bangladesh, including immunization, are needed.

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