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Kim CL, Cruz Espinoza LM, Vannice KS, Tadesse BT, Owusu-Dabo E, Rakotozandrindrainy R, Jani IV, Teferi M, Bassiahi Soura A, Lunguya O, Steele AD, Marks F. The Burden of Typhoid Fever in Sub-Saharan Africa: A Perspective. Res Rep Trop Med 2022; 13:1-9. [PMID: 35308424 PMCID: PMC8932916 DOI: 10.2147/rrtm.s282461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/12/2022] [Indexed: 11/23/2022] Open
Abstract
While typhoid fever has largely been eliminated in high-income regions which have developed modern water, sanitation, and hygiene facilities, it remains a significant public health burden resulting in morbidity and mortality among millions of individuals in resource-constrained settings. Prevention and control efforts are needed that integrate several high-impact interventions targeting facilities and infrastructure, including those addressing improvements in sanitation, access to safe water, and planned urbanization, together with parallel efforts directed at effective strategies for use of typhoid conjugate vaccines (TCV). The use of TCVs is a critical tool with the potential of having a rapid impact on typhoid fever disease burden; their introduction will also serve as an important strategy to combat evolving antimicrobial resistance to currently available typhoid fever treatments. Well-designed epidemiological surveillance studies play a critical role in establishing the need for, and monitoring the impact of, typhoid fever control and prevention strategies implemented by public health authorities. Here, we present a perspective based on a narrative review of the impact of typhoid fever on morbidity and mortality in sub-Saharan Africa and discuss ongoing surveillance activities and the role of vaccination in prevention and control efforts.
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Affiliation(s)
- Cara Lynn Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Kirsten S Vannice
- Enteric and Diarrheal Diseases, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Birkneh Tilahun Tadesse
- International Vaccine Institute, Seoul, Republic of 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
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Ilesh V Jani
- Instituto Nacional de Saúde (INS), Maputo Province, Mozambique
| | | | - Abdramane Bassiahi Soura
- Institut Supérieur des Sciences de la Population, Université Joseph Ki-Zerbo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Octavie Lunguya
- Department of Microbiology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Department of Medical Biology, University Teaching Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - A Duncan Steele
- Enteric and Diarrheal Diseases, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea
- University of Antananarivo, Antananarivo, Madagascar
- 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
- Correspondence: Florian Marks, Tel +82-2-881-1133, Email
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Jumani RS, Spector JM, Izadnegahdar R, Kelly P, Diagana TT, Manjunatha UH. Innovations in Addressing Pediatric Diarrhea in Low Resource Settings. ACS Infect Dis 2020; 6:14-24. [PMID: 31612701 DOI: 10.1021/acsinfecdis.9b00315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Diarrhea has long been recognized as an important cause of mortality during childhood. In parallel with ensuring access to proven care practices is the imperative to apply modern advances in medicine, science, and technology to accelerate progress against diarrheal disease, particularly in developing countries where the burden of avoidable harm is the greatest. In order to highlight achievements and identify outstanding areas of need, we reviewed the landscape of recent innovations that have significance for the study and clinical management of pediatric diarrhea in low resource settings.
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Affiliation(s)
- Rajiv S. Jumani
- Novartis Institute for Tropical Diseases, 5300 Chiron Way, Emeryville, California 94608, United States
| | - Jonathan M. Spector
- Novartis Institute for Tropical Diseases, 5300 Chiron Way, Emeryville, California 94608, United States
| | - Rasa Izadnegahdar
- Bill and Melinda Gates Foundation, 440 5th Ave N, Seattle, Washington 98109, United States
| | - Paul Kelly
- Blizard Institute, Barts and The London School of Medicine, Queen Mary University of London, Turner Street, London E1 2AD, United Kingdom
- Tropical Gastroenterology and Nutrition group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Thierry T. Diagana
- Novartis Institute for Tropical Diseases, 5300 Chiron Way, Emeryville, California 94608, United States
| | - Ujjini H. Manjunatha
- Novartis Institute for Tropical Diseases, 5300 Chiron Way, Emeryville, California 94608, United States
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Osei FB, Stein A, Nyadanu SD. Spatial and temporal heterogeneities of district-level typhoid morbidities in Ghana: A requisite insight for informed public health response. PLoS One 2018; 13:e0208006. [PMID: 30496258 PMCID: PMC6264858 DOI: 10.1371/journal.pone.0208006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 11/09/2018] [Indexed: 11/18/2022] Open
Abstract
Typhoid fever is estimated to cause between 9.9-24.2 million cases and 75,000-208,000 deaths per year globally. Low-income and middle-income countries report the majority of cases, especially those in sub-Saharan Africa. The epidemiology of typhoid fever is poorly understood, particularly in Ghana where there has been no study of the within-country variation. Our objective was to explore and analyze the spatial and temporal patterns of typhoid fever morbidities in Ghana. We used the global and local Moran's indices to uncover the existence of global and local spatial patterns, respectively. Generalized linear autoregressive moving average (glarma) models were developed to explore the overall and regional level temporal patterns of morbidities. The overall index of spatial association was 0.19 (p < 0.001). The global Moran's monthly indices of clustering ranged from ≈ 0 - 0.28, with few non-significant (p > 0.05) estimates. The yearly estimates were all significant (p < 0.001) and ranged from 0.1-0.19, suggesting spatial clustering of typhoid. The local Moran's maps indicated isolated high contributions of clustering within the Upper West and Western regions. The overall and regional level glarma models indicated significant first and second-order serial correlation as well as quarterly trends. These findings can provide relevant epidemiological insight into the spatial and temporal patterns of typhoid epidemiology and useful to complement the development of control strategies by public health managers.
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Affiliation(s)
- Frank Badu Osei
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands
| | - Alfred Stein
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands
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Cuypers WL, Jacobs J, Wong V, Klemm EJ, Deborggraeve S, Van Puyvelde S. Fluoroquinolone resistance in Salmonella: insights by whole-genome sequencing. Microb Genom 2018; 4. [PMID: 29975627 PMCID: PMC6113872 DOI: 10.1099/mgen.0.000195] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Fluoroquinolone (FQ)-resistant Salmonella spp. were listed by the WHO in 2017 as priority pathogens for which new antibiotics were urgently needed. The overall global burden of Salmonella infections is high, but differs per region. Whereas typhoid fever is most prevalent in South and South-East Asia, non-typhoidal salmonellosis is prevalent across the globe and associated with a mild gastroenteritis. By contrast, invasive non-typhoidal Salmonella cause bloodstream infections associated with high mortality, particularly in sub-Saharan Africa. Most Salmonella strains from clinical sources are resistant to first-line antibiotics, with FQs now being the antibiotic of choice for treatment of invasive Salmonella infections. However, FQ resistance is increasingly being reported in Salmonella, and multiple molecular mechanisms are already described. Whole-genome sequencing (WGS) is becoming more frequently used to analyse bacterial genomes for antibiotic-resistance markers, and to understand the phylogeny of bacteria in relation to their antibiotic-resistance profiles. This mini-review provides an overview of FQ resistance in Salmonella, guided by WGS studies that demonstrate that WGS is a valuable tool for global surveillance.
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Affiliation(s)
- Wim L Cuypers
- 1Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium.,2Department of Mathematics and Computer Science, University of Antwerp, Antwerpen, Belgium
| | - Jan Jacobs
- 3Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium.,4Department of Microbiology and Immunology, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium
| | - Vanessa Wong
- 5Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.,6Wellcome Trust Sanger Institute, Hinxton, UK
| | | | - Stijn Deborggraeve
- 1Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Sandra Van Puyvelde
- 6Wellcome Trust Sanger Institute, Hinxton, UK.,1Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
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