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Meta-Analysis
. 2016 Jan 29:16:35.
doi: 10.1186/s12879-016-1351-3.

Revisiting typhoid fever surveillance in low and middle income countries: lessons from systematic literature review of population-based longitudinal studies

Vittal Mogasale  1 , Vijayalaxmi V Mogasale  2 , Enusa Ramani  3 , Jung Seok Lee  4 , Ju Yeon Park  5 , Kang Sung Lee  6 , Thomas F Wierzba  7   8
Affiliations
Meta-Analysis

Revisiting typhoid fever surveillance in low and middle income countries: lessons from systematic literature review of population-based longitudinal studies

Vittal Mogasale et al. BMC Infect Dis. .

Abstract

Background: The control of typhoid fever being an important public health concern in low and middle income countries, improving typhoid surveillance will help in planning and implementing typhoid control activities such as deployment of new generation Vi conjugate typhoid vaccines.

Methods: We conducted a systematic literature review of longitudinal population-based blood culture-confirmed typhoid fever studies from low and middle income countries published from 1(st) January 1990 to 31(st) December 2013. We quantitatively summarized typhoid fever incidence rates and qualitatively reviewed study methodology that could have influenced rate estimates. We used meta-analysis approach based on random effects model in summarizing the hospitalization rates.

Results: Twenty-two papers presented longitudinal population-based and blood culture-confirmed typhoid fever incidence estimates from 20 distinct sites in low and middle income countries. The reported incidence and hospitalizations rates were heterogeneous as well as the study methodology across the sites. We elucidated how the incidence rates were underestimated in published studies. We summarized six categories of under-estimation biases observed in these studies and presented potential solutions.

Conclusions: Published longitudinal typhoid fever studies in low and middle income countries are geographically clustered and the methodology employed has a potential for underestimation. Future studies should account for these limitations.

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Figures

Fig. 1
Fig. 1
PRISMA diagram for systematic literature review conducted to identify population based longitudinal typhoid fever studies
Fig. 2
Fig. 2
Geographical location of population- based longitudinal typhoid fever studies identified based on systematic literature review (Source: DIVA-GIS (http://www.diva-gis.org))
Fig. 3
Fig. 3
Weighted mean hospitalization rates using random effects model in selected population- based longitudinal typhoid fever studies classified by regions
See this image and copyright information in PMC

References

    1. WHO Typhoid vaccines: WHO position paper. Wkly Epidemiol Rec. 2008;83(6):49–59. - PubMed
    1. WHO . Background document: the diagnosis, treatment and prevention of typhoid fever. Geneva, Switzerland: World Health Organization; 2003.
    1. Szu SC. Development of Vi conjugate - a new generation of typhoid vaccine. Expert Rev Vaccines. 2013;12(11):1273–1286. doi: 10.1586/14760584.2013.845529. - DOI - PubMed
    1. Neil KP, Sodha SV, Lukwago L, O-Tipo S, Mikoleit M, Simington SD, et al. A Large Outbreak of Typhoid Fever Associated With a High Rate of Intestinal Perforation in Kasese District, Uganda, 2008–2009. Clin Infect Dis. 2012;54(8):1091–99. doi: 10.1093/cid/cis025. - DOI - PubMed
    1. Bhutta ZA. Current concepts in the diagnosis and treatment of typhoid fever. BMJ. 2006;333(7558):78–82. doi: 10.1136/bmj.333.7558.78. - DOI - PMC - PubMed

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