The Typhoid Fever Surveillance in Africa Program (TSAP): Clinical, Diagnostic, and Epidemiological Methodologies

Vera Von Kalckreuth, Frank Konings, Peter Aaby, Yaw Adu-Sarkodie, Mohammad Ali, Abraham Aseffa, Stephen Baker, Robert F. Breiman, Morten Bjerregaard-Andersen, John D. Clemens, John A. Crump, Ligia Maria Cruz Espinoza, Jessica Fung Deerin, Nagla Gasmelseed, Amy Gassama Sow, Justin Im, Karen H. Keddy, Leonard Cosmas, Jürgen May, Christian G. MeyerEric D. Mintz, Joel M. Montgomery, Beatrice Olack, Gi Deok Pak, Ursula Panzner, Se Eun Park, Raphaël Rakotozandrindrainy, Heidi Schütt-Gerowitt, Abdramane Bassiahi Soura, Michelle R. Warren, Thomas F. Wierzba, Florian Marks

Research output: Contribution to journalArticle

Abstract

Background. New immunization programs are dependent on data from surveillance networks and disease burden estimates to prioritize target areas and risk groups. Data regarding invasive Salmonella disease in sub-Saharan Africa are currently limited, thus hindering the implementation of preventive measures. The Typhoid Fever Surveillance in Africa Program (TSAP) was established by the International Vaccine Institute to obtain comparable incidence data on typhoid fever and invasive nontyphoidal Salmonella (iNTS) disease in sub-Saharan Africa through standardized surveillance in multiple countries. Methods. Standardized procedures were developed and deployed across sites for study site selection, patient enrolment, laboratory procedures, quality control and quality assurance, assessment of healthcare utilization and incidence calculations. Results. Passive surveillance for bloodstream infections among febrile patients was initiated at thirteen sentinel sites in ten countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania). Each TSAP site conducted case detection using these standardized methods to isolate and identify aerobic bacteria from the bloodstream of febrile patients. Healthcare utilization surveys were conducted to adjust population denominators in incidence calculations for differing healthcare utilization patterns and improve comparability of incidence rates across sites. Conclusions. By providing standardized data on the incidence of typhoid fever and iNTS disease in sub-Saharan Africa, TSAP will provide vital input for targeted typhoid fever prevention programs.

Original languageEnglish (US)
Pages (from-to)s9-s16
JournalClinical Infectious Diseases
Volume62
DOIs
StatePublished - Mar 15 2016

Fingerprint

Typhoid Fever
Africa South of the Sahara
Health Care Quality Assurance
Salmonella
Incidence
Fever
Guinea-Bissau
Health Care Surveys
Burkina Faso
Madagascar
Senegal
Immunization Programs
Aerobic Bacteria
Ghana
Ethiopia
Tanzania
Kenya
South Africa
Quality Control
Patient Selection

Keywords

  • Africa
  • invasive Salmonella disease
  • methodology
  • surveillance
  • typhoid fever

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

The Typhoid Fever Surveillance in Africa Program (TSAP) : Clinical, Diagnostic, and Epidemiological Methodologies. / Von Kalckreuth, Vera; Konings, Frank; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Breiman, Robert F.; Bjerregaard-Andersen, Morten; Clemens, John D.; Crump, John A.; Cruz Espinoza, Ligia Maria; Deerin, Jessica Fung; Gasmelseed, Nagla; Sow, Amy Gassama; Im, Justin; Keddy, Karen H.; Cosmas, Leonard; May, Jürgen; Meyer, Christian G.; Mintz, Eric D.; Montgomery, Joel M.; Olack, Beatrice; Pak, Gi Deok; Panzner, Ursula; Park, Se Eun; Rakotozandrindrainy, Raphaël; Schütt-Gerowitt, Heidi; Soura, Abdramane Bassiahi; Warren, Michelle R.; Wierzba, Thomas F.; Marks, Florian.

In: Clinical Infectious Diseases, Vol. 62, 15.03.2016, p. s9-s16.

Research output: Contribution to journalArticle

Von Kalckreuth, V, Konings, F, Aaby, P, Adu-Sarkodie, Y, Ali, M, Aseffa, A, Baker, S, Breiman, RF, Bjerregaard-Andersen, M, Clemens, JD, Crump, JA, Cruz Espinoza, LM, Deerin, JF, Gasmelseed, N, Sow, AG, Im, J, Keddy, KH, Cosmas, L, May, J, Meyer, CG, Mintz, ED, Montgomery, JM, Olack, B, Pak, GD, Panzner, U, Park, SE, Rakotozandrindrainy, R, Schütt-Gerowitt, H, Soura, AB, Warren, MR, Wierzba, TF & Marks, F 2016, 'The Typhoid Fever Surveillance in Africa Program (TSAP): Clinical, Diagnostic, and Epidemiological Methodologies', Clinical Infectious Diseases, vol. 62, pp. s9-s16. https://doi.org/10.1093/cid/civ693
Von Kalckreuth, Vera ; Konings, Frank ; Aaby, Peter ; Adu-Sarkodie, Yaw ; Ali, Mohammad ; Aseffa, Abraham ; Baker, Stephen ; Breiman, Robert F. ; Bjerregaard-Andersen, Morten ; Clemens, John D. ; Crump, John A. ; Cruz Espinoza, Ligia Maria ; Deerin, Jessica Fung ; Gasmelseed, Nagla ; Sow, Amy Gassama ; Im, Justin ; Keddy, Karen H. ; Cosmas, Leonard ; May, Jürgen ; Meyer, Christian G. ; Mintz, Eric D. ; Montgomery, Joel M. ; Olack, Beatrice ; Pak, Gi Deok ; Panzner, Ursula ; Park, Se Eun ; Rakotozandrindrainy, Raphaël ; Schütt-Gerowitt, Heidi ; Soura, Abdramane Bassiahi ; Warren, Michelle R. ; Wierzba, Thomas F. ; Marks, Florian. / The Typhoid Fever Surveillance in Africa Program (TSAP) : Clinical, Diagnostic, and Epidemiological Methodologies. In: Clinical Infectious Diseases. 2016 ; Vol. 62. pp. s9-s16.
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T1 - The Typhoid Fever Surveillance in Africa Program (TSAP)

T2 - Clinical, Diagnostic, and Epidemiological Methodologies

AU - Von Kalckreuth, Vera

AU - Konings, Frank

AU - Aaby, Peter

AU - Adu-Sarkodie, Yaw

AU - Ali, Mohammad

AU - Aseffa, Abraham

AU - Baker, Stephen

AU - Breiman, Robert F.

AU - Bjerregaard-Andersen, Morten

AU - Clemens, John D.

AU - Crump, John A.

AU - Cruz Espinoza, Ligia Maria

AU - Deerin, Jessica Fung

AU - Gasmelseed, Nagla

AU - Sow, Amy Gassama

AU - Im, Justin

AU - Keddy, Karen H.

AU - Cosmas, Leonard

AU - May, Jürgen

AU - Meyer, Christian G.

AU - Mintz, Eric D.

AU - Montgomery, Joel M.

AU - Olack, Beatrice

AU - Pak, Gi Deok

AU - Panzner, Ursula

AU - Park, Se Eun

AU - Rakotozandrindrainy, Raphaël

AU - Schütt-Gerowitt, Heidi

AU - Soura, Abdramane Bassiahi

AU - Warren, Michelle R.

AU - Wierzba, Thomas F.

AU - Marks, Florian

PY - 2016/3/15

Y1 - 2016/3/15

N2 - Background. New immunization programs are dependent on data from surveillance networks and disease burden estimates to prioritize target areas and risk groups. Data regarding invasive Salmonella disease in sub-Saharan Africa are currently limited, thus hindering the implementation of preventive measures. The Typhoid Fever Surveillance in Africa Program (TSAP) was established by the International Vaccine Institute to obtain comparable incidence data on typhoid fever and invasive nontyphoidal Salmonella (iNTS) disease in sub-Saharan Africa through standardized surveillance in multiple countries. Methods. Standardized procedures were developed and deployed across sites for study site selection, patient enrolment, laboratory procedures, quality control and quality assurance, assessment of healthcare utilization and incidence calculations. Results. Passive surveillance for bloodstream infections among febrile patients was initiated at thirteen sentinel sites in ten countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania). Each TSAP site conducted case detection using these standardized methods to isolate and identify aerobic bacteria from the bloodstream of febrile patients. Healthcare utilization surveys were conducted to adjust population denominators in incidence calculations for differing healthcare utilization patterns and improve comparability of incidence rates across sites. Conclusions. By providing standardized data on the incidence of typhoid fever and iNTS disease in sub-Saharan Africa, TSAP will provide vital input for targeted typhoid fever prevention programs.

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