TY - JOUR
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.
N1 - Funding Information:
This research protocol was funded by the Centers for Disease Control and Prevention, Atlanta, GA, USA and by the International Vaccine Institute, Seoul (Diseases of the Most Impoverished Program: grant number DOMI T-18). ICDDR,B acknowledges with gratitude the commitment of both institutions to the Center's research efforts. The authors affiliated with the CDC were involved in the study design, in the collection, analysis and interpretation of data, in the writing of the manuscript, and in the decision to submit the manuscript for publication. We gratefully acknowledge the contributions of the Kamalapur active surveillance population, Dr Doli Goswami and her team for data collection, Ms Bilkis Ara and her team for data management, and Mr Khorshed Alam, Ms Ishrat Jahan Azmi and Mr Zhahirul Islam for providing laboratory support. Conflict of interest: No conflict of interest to declare.
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.
KW - Bangladesh
KW - Burden
KW - Typhoid and paratyphoid fever
KW - Urban
UR - http://www.scopus.com/inward/record.url?scp=77957350013&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77957350013&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2009.11.023
DO - 10.1016/j.ijid.2009.11.023
M3 - Article
C2 - 20236850
AN - SCOPUS:77957350013
SN - 1201-9712
VL - 14
SP - e93-e99
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
IS - SUPPL. 3
ER -