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Review
. 2021 May 29:11:04031.
doi: 10.7189/jogh.11.04031.

A review of toolkits and case definitions for detecting enteric fever outbreaks in Asian and African countries from 1965-2019

Asif Khaliq  1   2 , Mohammad Tahir Yousafzai  1   3 , Salman Haq  4 , Rahima Yaseen  4 , Sonia Qureshi  1 , Fahad Rind  1 , Zahra A Padhani  5 , Ayub Khan  1 , Abdul Momin Kazi  1 , Farah Naz Qamar  1
Affiliations
Review

A review of toolkits and case definitions for detecting enteric fever outbreaks in Asian and African countries from 1965-2019

Asif Khaliq et al. J Glob Health. .

Abstract

Background: This review assessed the case definitions, diagnostic criteria, antimicrobial resistance, and methods used for enteric fever outbreaks and utilization of any unified outbreak score or checklist for early identification and response in Asia and Africa from 1965-2019.

Methods: We searched enteric fever outbreaks using PubMed, Google Scholar, and the Cochrane library. Studies describing a single outbreak event of enteric fever in Asia and Africa from 1965-2019 were reviewed. We excluded case reports, letter to editors, studies reporting typhoid in conjunction with other diseases, the Centers for Disease Control and Prevention (CDC) trip reports, the World Health Organization (WHO) bulletins report, data from mathematical modeling and simulation studies, reviews and ProMed alert. Also, non-typhoidal salmonella outbreaks were excluded.

Results: A total of 5063 articles were identified using the key terms and 68 studies were selected for data extraction. Most (48, 71%) outbreaks were from Asian countries, 20 (29%) were reported from Africa. Only 15 studies reported the case definition used for case identification during an outbreak and 8 of those were from Asia. A third (20, 29%) of the studies described antibiotic resistance pattern. 43 (63%) studies contained information regarding the source of the outbreak. Outcomes (hospitalization and deaths) were reported in a quarter of studies. Only 23 (29%) of the studies reported outbreak control strategies while none reported any unified outbreak score or a checklist to identify the outbreak.

Conclusion: This review highlights the variability in detection and reporting methods for enteric fever outbreaks in Asia and Africa. No standardized case definitions or laboratory methods were reported. Only a few studies reported strategies for outbreak control. There is a need for the development of a unified outbreak score or a checklist to identify and report enteric fever outbreaks globally.

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Conflict of interest statement

Competing interests: The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Geographical distribution of Enteric fever outbreaks in different countries of Asia and Africa.
See this image and copyright information in PMC

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