Population-based surveillance of typhoid fever in Egypt.


Journal Article

Credible measures of disease incidence are necessary to guide typhoid fever control efforts. In Egypt, incidence estimates have been derived from hospital-based syndromic surveillance, which may not represent the population with typhoid fever. To determine the population-based incidence of typhoid fever in Fayoum Governorate (pop. 2,240,000), we established laboratory-based surveillance at five tiers of health care. Incidence estimates were adjusted for sampling and test sensitivity. Of 1,815 patients evaluated, cultures yielded 90 (5%) Salmonella Typhi isolates. The estimated incidence of typhoid fever was 59/100,000 persons/year. We estimate 71% of typhoid fever patients are managed by primary care providers. Multidrug-resistant (MDR) Salmonella Typhi (resistant to chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole) was isolated from 26 (29%) patients. Population-based surveillance indicates moderate typhoid fever incidence in Fayoum, and a concerning prevalence of MDR typhoid. The majority of patients are evaluated at the primary care level and would not have been detected by hospital-based surveillance.

Full Text

Duke Authors

Cited Authors

  • Srikantiah, P; Girgis, FY; Luby, SP; Jennings, G; Wasfy, MO; Crump, JA; Hoekstra, RM; Anwer, M; Mahoney, FJ

Published Date

  • January 2006

Published In

Volume / Issue

  • 74 / 1

Start / End Page

  • 114 - 119

PubMed ID

  • 16407354

Pubmed Central ID

  • 16407354

International Standard Serial Number (ISSN)

  • 0002-9637


  • eng

Conference Location

  • United States