Costs of illness due to typhoid fever in an Indian urban slum community: Implications for vaccination policy

Rajiv Bahl, Anju Sinha, Christine Poulos, Dale Whittington, Sunil Sazawal, Ramesh Kumar, Dilip Mahalanabis, Camilo J. Acosta, John D. Clemens, Maharaj K. Bhan

Research output: Contribution to journalArticle


Data on the burden of disease, costs of illness, and cost-effectiveness of vaccines are needed to facilitate the use of available anti-typhoid vaccines in developing countries. This one-year prospective surveillance was carried out in an urban slum community in Delhi, India, to estimate the costs of illness for cases of typhoid fever. Ninety-eight culture-positive typhoid, 31 culture-positive paratyphoid, and 94 culture-negative cases with clinical typhoid syndrome were identified during the surveillance. Estimates of costs of illness were based on data collected through weekly interviews conducted at home for three months following diagnosis. Private costs included the sum of direct medical, direct non-medical, and indirect costs. Non-patient (public) costs included costs of outpatient visits, hospitalizations, laboratory tests, and medicines provided free of charge to the families. The mean cost per episode of blood culture-confirmed typhoid fever was 3,597 Indian Rupees (US$ 1=INR 35.5) (SD 5,833); hospitalization increased the costs by several folds (INR 18,131, SD 11,218, p

Original languageEnglish (US)
Pages (from-to)304-310
Number of pages7
JournalJournal of Health, Population and Nutrition
Issue number3
StatePublished - Sep 2004



  • Cost of illness
  • Cost-benefit analysis
  • Costs and cost analysis
  • India
  • Prospective studies
  • Slums
  • Typhoid and paratyphoid vaccines
  • Typhoid fever
  • Vaccination

ASJC Scopus subject areas

  • Environmental Science(all)
  • Environmental Chemistry
  • Public Health, Environmental and Occupational Health

Cite this

Bahl, R., Sinha, A., Poulos, C., Whittington, D., Sazawal, S., Kumar, R., Mahalanabis, D., Acosta, C. J., Clemens, J. D., & Bhan, M. K. (2004). Costs of illness due to typhoid fever in an Indian urban slum community: Implications for vaccination policy. Journal of Health, Population and Nutrition, 22(3), 304-310.