Effectiveness of typhoid conjugate vaccine against culture-confirmed typhoid in a peri-urban setting in Karachi: A case-control study

Batool, Rabab; Yousafzai, Mohammad Tahir; Qureshi, Sonia; Ali, Miqdad; Sadaf, Tahira; Mehmood, Junaid; Ashorn, Per

doi:10.1016/j.vaccine.2021.08.051

Cited by 14 publications

(9 citation statements)

References 20 publications

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“…This observation is supported by the work done by Rabab Batool, et al and Yousufzai, et al in 2021 where they found TCV effectiveness among children and adolescents in XDR typhoid Outbreak. 25,26 Enteric fever is an infection manifesting multisystem involvement and rapid disease progression. Same holds true for our enrolled subjects where majority (96.5%) presented with multiple symptoms i.e., lengthy fever (41.6%), abdominal pain, anorexia, vomiting, diarrhea, myalgias, headaches (95.6% collectively) etc.…”

Section: Discussionmentioning

confidence: 99%

Association of extensively drug resistant salmonella infection in children with typhoid fever

Memon

Saeed²,

Iqbal³

et al. 2022

Pak J Med Sci

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Objectives: In resource limited countries facing a huge burden of multidrug resistant and extensively drug resistant (XDR) enteric fever, treatment is a great challenge on the part of a patient as well as a health care professional. This study was conducted to determine the association of XDR enteric fever with various studied factors among hospitalized culture-positive pediatric patients in a tertiary care hospital setup. Methods: We conducted a descriptive observational study at The Karachi Adventist Hospital from July 01, 2019, to March 31, 2020 on 143 hospitalized children with culture proven enteric fever who were already on empirical antibiotics. Depending on the variability of the course of illness and clinical responses to given antibiotics, the data was gathered on a structured data sheet. Association of various study parameters and their significance in relation to XDR salmonella infection was analyzed and studied. Results: The age group highly affected was 5-7.5 years, with a male preponderance of 61.5%. Majority were from urban slums areas of Karachi (53.8%) and 52% were admitted between 7 to 14 days of fever onset. XDR salmonella infection was observed in 79% of blood culture isolates. None of the XDR patients were consuming boiled water and neither of these infected children were vaccinated against salmonella typhi. Duration of fever before hospitalization, non-consumption of boiled or mineral water, ciprofloxacin use and lack of typhoid vaccination showed statistically strong association with XDR enteric fever (p<0.01). Conclusion: Prehospitalization fever duration, use of boiled/mineral water, ciprofloxacin use and typhoid vaccine status showed strong association with XDR salmonella infection. Prioritizing the focus on healthcare awareness, early access to proper health care facility, discouraging over-the-counter drugs and enforcement of immunization will help decline the dissemination of this dreadful disease. doi: https://doi.org/10.12669/pjms.38.7.5868 How to cite this:Memon H, Saeed F, Iqbal M, Saboohi E, Hanif S, Mallick AHH. Association of extensively drug resistant salmonella infection in children with typhoid fever. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.5868 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Association of extensively drug resistant salmonella infection in children with typhoid fever

Memon

Saeed²,

Iqbal³

et al. 2022

Pak J Med Sci

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“…The emergence of XDR S . Typhi can be considered an inflection point in typhoid fever control, providing an impetus to roll out TCVs more broadly to address the challenge of antimicrobial resistance [29 ▪▪ ,30].…”

Section: Treatmentmentioning

confidence: 99%

“…A mass vaccination campaign using Typbar-TCV was also conducted in Lyari Town (an urban slum neighbourhood of Karachi, Pakistan) in response to the spread of XDR typhoid to this area. Effectiveness was evaluated using a matched case-control design [30]. Surveillance was conducted at three hospitals from August to December 2019, and children aged 6 months to 15 years presenting to a study facility with blood culture-confirmed S. Typhi were counted as cases.…”

Section: The Era Of Tyhpoid Conjugate Vaccinesmentioning

confidence: 99%

Typhoid fever control in the 21st century: where are we now?

Carey

McCann

Gibani

2022

Current Opinion in Infectious Diseases

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Purpose of reviewMomentum for achieving widespread control of typhoid fever has been growing over the past decade. Typhoid conjugate vaccines represent a potentially effective tool to reduce the burden of disease in the foreseeable future and new data have recently emerged to better frame their use-case.Recent findingsWe describe how antibiotic resistance continues to pose a major challenge in the treatment of typhoid fever, as exemplified by the emergence of azithromycin resistance and the spread of Salmonella Typhi strains resistant to third-generation cephalosporins. We review efficacy and effectiveness data for TCVs, which have been shown to have high-level efficacy (≥80%) against typhoid fever in diverse field settings. Data from randomized controlled trials and observational studies of TCVs are reviewed herein. Finally, we review data from multicountry blood culture surveillance studies that have provided granular insights into typhoid fever epidemiology. These data are becoming increasingly important as countries decide how best to introduce TCVs into routine immunization schedules and determine the optimal delivery strategy.SummaryContinued advocacy is needed to address the ongoing challenge of typhoid fever to improve child health and tackle the rising challenge of antimicrobial resistance.

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“…In Zimbabwe, within three months of initiating the campaign there was a decrease in number of blood culture-confirmed typhoid cases (440). An evaluation of over 200,000 children in the Pakistan campaign found a vaccine effectiveness of 55 percent and 97 percent against extensively drug-resistant S. Typhi (441) and a separate, smaller casecontrol study in Pakistan found a vaccine effectiveness of 72 percent (442). Similarly, a clusterrandomized study of over 60,000 children in Bangladesh found an overall vaccine protection of 57 percent (443).…”

Section: Development Of Vaccines Against Salmonellamentioning

confidence: 99%

Controlled Human Infection Models To Accelerate Vaccine Development

et al. 2022

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The timelines for developing vaccines against infectious diseases are lengthy, and often vaccines that reach the stage of large phase 3 field trials fail to provide the desired level of protective efficacy. The application of controlled human challenge models of infection and disease at the appropriate stages of development could accelerate development of candidate vaccines and, in fact, has done so successfully in some limited cases.

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Effectiveness of typhoid conjugate vaccine against culture-confirmed typhoid in a peri-urban setting in Karachi: A case-control study

Cited by 14 publications

References 20 publications

Association of extensively drug resistant salmonella infection in children with typhoid fever

Association of extensively drug resistant salmonella infection in children with typhoid fever

Typhoid fever control in the 21st century: where are we now?

Controlled Human Infection Models To Accelerate Vaccine Development

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