Part I. Analysis of data gaps pertaining to Salmonella enterica serotype Typhi infections in low and medium human development index countries, 1984-2005.

Published

Journal Article (Review)

There are only 10 contemporary, population-based studies of typhoid fever that evaluate disease incidence using blood culture for confirmation of cases. Reported incidence ranged from 13 to 976/100 000 persons per year. These studies are likely to have been done preferentially in high- incidence sites which makes generalization of data difficult. Only five of these studies reported mortality. Of these the median (range) mortality was 0% (0-1.8%). Since study conditions usually involved enhanced clinical management of patients and the studies were not designed to evaluate mortality as an outcome, their usefulness for generalizing case-fatality rates is uncertain. No contemporary population-based studies reported rates of complications. Hospital-based typhoid fever studies reported median (range) complication rates of 2.8% (0.6-4.9%) for intestinal perforation and case-fatality rates of 2.0% (0-14.8%). Rates of complications other than intestinal perforation were not reported in contemporary hospital-based studies. Hospital-based studies capture information on the most severe illnesses among persons who have access to health-care services limiting their generalizability. Only two studies have informed the current understanding of typhoid fever age distribution curves. Extrapolation from population-based studies suggests that most typhoid fever occurs among young children in Asia. To reduce gaps in the current understanding of typhoid fever incidence, complications, and case-fatality rate, large population-based studies using blood culture confirmation of cases are needed in representative sites, especially in low and medium human development index countries outside Asia.

Full Text

Duke Authors

Cited Authors

  • Crump, JA; Ram, PK; Gupta, SK; Miller, MA; Mintz, ED

Published Date

  • April 2008

Published In

Volume / Issue

  • 136 / 4

Start / End Page

  • 436 - 448

PubMed ID

  • 17686194

Pubmed Central ID

  • 17686194

International Standard Serial Number (ISSN)

  • 0950-2688

Digital Object Identifier (DOI)

  • 10.1017/S0950268807009338

Language

  • eng

Conference Location

  • England