. 2024 Apr;12(4):e599-e610.

doi: 10.1016/S2214-109X(24)00007-X.

Incidence of typhoid fever in Burkina Faso, Democratic Republic of the Congo, Ethiopia, Ghana, Madagascar, and Nigeria (the Severe Typhoid in Africa programme): a population-based study

Florian Marks¹, Justin Im², Se Eun Park³, Gi Deok Pak², Hyon Jin Jeon⁴, Lady Rosny Wandji Nana⁵, Marie-France Phoba⁶, Lisette Mbuyi-Kalonji⁶, Ondari D Mogeni², Biruk Yeshitela⁷, Ursula Panzner², Ligia María Cruz Espinoza², Tigist Beyene⁷, Michael Owusu-Ansah⁸, Sampson Twumasi-Ankrah⁹, Melese Yeshambaw⁷, Ashenafi Alemu¹⁰, Oluwafemi J Adewusi¹¹, Olukemi Adekanmbi¹², Ellen Higginson¹³, Akinlolu Adepoju¹⁴, Sarah Agbi¹⁰, Enoch G Cakpo⁵, Veronica O Ogunleye¹⁵, Gaëlle Nkoji Tunda¹⁶, Odion O Ikhimiukor¹⁷, Jules Mbuyamba⁶, Trevor Toy², Francis Opoku Agyapong¹⁸, Isaac Osei¹⁹, John Amuasi²⁰, Tsiriniaina Jean Luco Razafindrabe²¹, Tiana Mirana Raminosoa²¹, Gabriel Nyirenda², Njariharinjakampionona Randriamampionona²¹, Hyeong Won Seo², Hyejin Seo², Mohamadou Siribie², Megan E Carey²², Michael Owusu²³, Christian G Meyer²⁴, Ndrainaharimira Rakotozandrindrainy²¹, Nimarko Sarpong⁸, Mathilde Razafindrakalia²¹, Ravomialisoa Razafimanantsoa²¹, Moussa Ouedraogo²⁵, Yeonseon J Kim², Jooah Lee²⁶, Raphaël M Zellweger², Sophie S Y Kang², Ju Yeon Park²⁷, John A Crump²⁸, Liselotte Hardy²⁹, Jan Jacobs³⁰, Denise O Garrett³¹, Jason R Andrews³², Nimesh Poudyal², Deok Ryun Kim², John D Clemens³³, Stephen G Baker¹³, Jerome H Kim³⁴, Gordon Dougan¹³, Jonathan D Sugimoto³⁵, Sandra Van Puyvelde³⁶, Aderemi Kehinde³⁷, Oluwafemi A Popoola³⁸, Vittal Mogasale², Robert F Breiman³⁹, William R MacWright⁴⁰, Abraham Aseffa⁷, Birkneh Tilahun Tadesse⁴¹, Andrea Haselbeck², Yaw Adu-Sarkodie⁴², Mekonnen Teferi⁷, Abdramane Soura Bassiahi⁵, Iruka N Okeke¹⁷, Octavie Lunguya-Metila⁶, Ellis Owusu-Dabo⁸, Raphaël Rakotozandrindrainy²¹

Affiliations

¹ International Vaccine Institute, Seoul, South Korea; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK; Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany; Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar. Electronic address: fmarks@ivi.int.
² International Vaccine Institute, Seoul, South Korea.
³ International Vaccine Institute, Seoul, South Korea; Yonsei University Graduate School of Public Health, Seoul, South Korea; Yonsei University Graduate School of Public Health, Seoul, South Korea.
⁴ International Vaccine Institute, Seoul, South Korea; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK; Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar.
⁵ Institut Supérieur des Sciences de la Population, Ouagadougou, Burkina Faso.
⁶ Department of Microbiology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Department of Medical Biology, Microbiology Service, University Teaching Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
⁷ Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
⁸ School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
⁹ School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Department of Statistics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
¹⁰ Department of Medicine, University of Ibadan, Ibadan, Nigeria.
¹¹ College of Medicine, University of Ibadan, Ibadan, Nigeria.
¹² Department of Medicine, University of Ibadan, Ibadan, Nigeria; Department of Community Medicine, University College Hospital, Ibadan, Nigeria.
¹³ Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
¹⁴ Department of Paediatrics, University of Ibadan, Ibadan, Nigeria; Department of Community Medicine, University College Hospital, Ibadan, Nigeria.
¹⁵ Department of Community Medicine, University College Hospital, Ibadan, Nigeria.
¹⁶ Department of Microbiology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Faculty of Medicine, Congo Protestant University, Kinshasa, Democratic Republic of the Congo.
¹⁷ Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria.
¹⁸ Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
¹⁹ Medical Research Council Unit, The Gambia at London School of Hygiene & Tropical Medicine, Banjul, The Gambia; Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
²⁰ School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany; Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana.
²¹ Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar.
²² Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK; International AIDS Vaccine Initiative, Chelsea & Westminster Hospital, London, UK.
²³ Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Centre for Health System Strengthening (CfHSS), Kumasi, Ghana; Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana.
²⁴ Institute of Tropical Medicine, Eberhard-Karls University Tübingen, Tübingen, Germany; Duy Tan University, Da Nang, Viet Nam.
²⁵ Hôpital Protestant Schiphra, Ouagadougou, Burkina Faso.
²⁶ International Vaccine Institute, Seoul, South Korea; Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
²⁷ International Vaccine Institute, Seoul, South Korea; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
²⁸ Centre for International Health, University of Otago, Dunedin, New Zealand.
²⁹ Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
³⁰ Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven Belgium.
³¹ Sabin Vaccine Institute, Washington, DC, USA.
³² Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
³³ International Vaccine Institute, Seoul, South Korea; Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
³⁴ International Vaccine Institute, Seoul, South Korea; Department of Life Sciences, College of Natural Sciences, Seoul National University, Seoul, South Korea.
³⁵ International Vaccine Institute, Seoul, South Korea; Epidemiologic Research and Information Center, Cooperative Studies Program, Office of Research and Development, United States Department of Veterans Affairs, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA USA.
³⁶ Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK; Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerpen, Belgium.
³⁷ Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
³⁸ Department of Community Medicine, University College Hospital, Ibadan, Nigeria; Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.
³⁹ Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Infectious Diseases and Oncology Research Institute, University of the Witwatersrand, Johannesburg, South Africa.
⁴⁰ Public Health Surveillance Group, Princeton, NJ, USA.
⁴¹ International Vaccine Institute, Seoul, South Korea; Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden; Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁴² School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

PMID: 38485427
PMCID: PMC10951957
DOI: 10.1016/S2214-109X(24)00007-X

Incidence of typhoid fever in Burkina Faso, Democratic Republic of the Congo, Ethiopia, Ghana, Madagascar, and Nigeria (the Severe Typhoid in Africa programme): a population-based study

Florian Marks et al. Lancet Glob Health. 2024 Apr.

. 2024 Apr;12(4):e599-e610.

doi: 10.1016/S2214-109X(24)00007-X.

Authors

Affiliations

¹ International Vaccine Institute, Seoul, South Korea; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK; Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany; Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar. Electronic address: fmarks@ivi.int.
² International Vaccine Institute, Seoul, South Korea.
³ International Vaccine Institute, Seoul, South Korea; Yonsei University Graduate School of Public Health, Seoul, South Korea; Yonsei University Graduate School of Public Health, Seoul, South Korea.
⁴ International Vaccine Institute, Seoul, South Korea; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK; Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar.
⁵ Institut Supérieur des Sciences de la Population, Ouagadougou, Burkina Faso.
⁶ Department of Microbiology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Department of Medical Biology, Microbiology Service, University Teaching Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
⁷ Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
⁸ School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
⁹ School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Department of Statistics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
¹⁰ Department of Medicine, University of Ibadan, Ibadan, Nigeria.
¹¹ College of Medicine, University of Ibadan, Ibadan, Nigeria.
¹² Department of Medicine, University of Ibadan, Ibadan, Nigeria; Department of Community Medicine, University College Hospital, Ibadan, Nigeria.
¹³ Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
¹⁴ Department of Paediatrics, University of Ibadan, Ibadan, Nigeria; Department of Community Medicine, University College Hospital, Ibadan, Nigeria.
¹⁵ Department of Community Medicine, University College Hospital, Ibadan, Nigeria.
¹⁶ Department of Microbiology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Faculty of Medicine, Congo Protestant University, Kinshasa, Democratic Republic of the Congo.
¹⁷ Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria.
¹⁸ Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
¹⁹ Medical Research Council Unit, The Gambia at London School of Hygiene & Tropical Medicine, Banjul, The Gambia; Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
²⁰ School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany; Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana.
²¹ Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar.
²² Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK; International AIDS Vaccine Initiative, Chelsea & Westminster Hospital, London, UK.
²³ Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Centre for Health System Strengthening (CfHSS), Kumasi, Ghana; Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana.
²⁴ Institute of Tropical Medicine, Eberhard-Karls University Tübingen, Tübingen, Germany; Duy Tan University, Da Nang, Viet Nam.
²⁵ Hôpital Protestant Schiphra, Ouagadougou, Burkina Faso.
²⁶ International Vaccine Institute, Seoul, South Korea; Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
²⁷ International Vaccine Institute, Seoul, South Korea; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
²⁸ Centre for International Health, University of Otago, Dunedin, New Zealand.
²⁹ Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
³⁰ Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven Belgium.
³¹ Sabin Vaccine Institute, Washington, DC, USA.
³² Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
³³ International Vaccine Institute, Seoul, South Korea; Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
³⁴ International Vaccine Institute, Seoul, South Korea; Department of Life Sciences, College of Natural Sciences, Seoul National University, Seoul, South Korea.
³⁵ International Vaccine Institute, Seoul, South Korea; Epidemiologic Research and Information Center, Cooperative Studies Program, Office of Research and Development, United States Department of Veterans Affairs, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA USA.
³⁶ Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK; Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerpen, Belgium.
³⁷ Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
³⁸ Department of Community Medicine, University College Hospital, Ibadan, Nigeria; Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.
³⁹ Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Infectious Diseases and Oncology Research Institute, University of the Witwatersrand, Johannesburg, South Africa.
⁴⁰ Public Health Surveillance Group, Princeton, NJ, USA.
⁴¹ International Vaccine Institute, Seoul, South Korea; Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden; Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁴² School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

PMID: 38485427
PMCID: PMC10951957
DOI: 10.1016/S2214-109X(24)00007-X

Erratum in

Correction to Lancet Glob Health 2024; 12: e599-610.
[No authors listed] [No authors listed] Lancet Glob Health. 2024 Jun;12(6):e918. doi: 10.1016/S2214-109X(24)00136-0. Epub 2024 Apr 9. Lancet Glob Health. 2024. PMID: 38608676 Free PMC article. No abstract available.

Abstract

Background: Typhoid Fever remains a major cause of morbidity and mortality in low-income settings. The Severe Typhoid in Africa programme was designed to address regional gaps in typhoid burden data and identify populations eligible for interventions using novel typhoid conjugate vaccines.

Methods: A hybrid design, hospital-based prospective surveillance with population-based health-care utilisation surveys, was implemented in six countries in sub-Saharan Africa. Patients presenting with fever (≥37·5°C axillary or ≥38·0°C tympanic) or reporting fever for three consecutive days within the previous 7 days were invited to participate. Typhoid fever was ascertained by culture of blood collected upon enrolment. Disease incidence at the population level was estimated using a Bayesian mixture model.

Findings: 27 866 (33·8%) of 82 491 participants who met inclusion criteria were recruited. Blood cultures were performed for 27 544 (98·8%) of enrolled participants. Clinically significant organisms were detected in 2136 (7·7%) of these cultures, and 346 (16·2%) Salmonella enterica serovar Typhi were isolated. The overall adjusted incidence per 100 000 person-years of observation was highest in Kavuaya and Nkandu 1, Democratic Republic of the Congo (315, 95% credible interval 254-390). Overall, 46 (16·4%) of 280 tested isolates showed ciprofloxacin non-susceptibility.

Interpretation: High disease incidence (ie, >100 per 100 000 person-years of observation) recorded in four countries, the prevalence of typhoid hospitalisations and complicated disease, and the threat of resistant typhoid strains strengthen the need for rapid dispatch and implementation of effective typhoid conjugate vaccines along with measures designed to improve clean water, sanitation, and hygiene practices.

Funding: The Bill & Melinda Gates Foundation.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests We declare no competing interests.

Figures

See this image and copyright information in PMC

Comment in

High burden of typhoid disease in sub-Saharan Africa calls for urgent roll-out of typhoid conjugate vaccines.
Kariuki S, Onsare RS. Kariuki S, et al. Lancet Glob Health. 2024 Apr;12(4):e537-e538. doi: 10.1016/S2214-109X(24)00079-2. Lancet Glob Health. 2024. PMID: 38485416 No abstract available.

References

1. Stanaway JD, Reiner RC, Blacker BF, et al. The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Infect Dis. 2019;19:369–381. - PMC - PubMed
1. Tadesse BT, Khanam F, Ahmed F, et al. Prevention of typhoid by Vi conjugate vaccine and achievable improvements in household water, sanitation, hygeine: evidence from a cluster-randomized trial in Dhaka, Bangladesh. Clin Infect Dis. 2022;75:1681–1687. - PMC - PubMed
1. WHO Typhoid. March 30, 2018. https://www.who.int/news-room/fact-sheets/detail/typhoid
1. Garrett DO, Longley AT, Aiemjoy K, et al. Incidence of typhoid and paratyphoid fever in Bangladesh, Nepal, and Pakistan: results of the Surveillance for Enteric Fever in Asia Project. Lancet Glob Health. 2022;10:e978–e988. - PMC - PubMed
1. Luby SP. Urban slums: a supportive ecosystem for Typhoidal Salmonellae. J Infect Dis. 2018;218(suppl 4):S250–S254. - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Incidence of typhoid fever in Burkina Faso, Democratic Republic of the Congo, Ethiopia, Ghana, Madagascar, and Nigeria (the Severe Typhoid in Africa programme): a population-based study

Affiliations

Incidence of typhoid fever in Burkina Faso, Democratic Republic of the Congo, Ethiopia, Ghana, Madagascar, and Nigeria (the Severe Typhoid in Africa programme): a population-based study

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

Figures

Comment in

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous