Incidence of Typhoid Bacteremia in Infants and Young Children in Southern Coastal Pakistan

Owais, Aatekah; Sultana, Shazia; Zaman, Umber; Rizvi, Arjumand; Zaidi, Anita K. M.

doi:10.1097/inf.0b013e3181e39f8b

Cited by 55 publications

(37 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The S.Typhi resistance to fluoroquinolones of 91.7%was observed in this review during 2011, much higher than the 5%-30% resistance to fluoroquinolones seen in India [17,18,36], and higher than the previously reported 54% resistance seen in children in southern Pakistan in 2007-2008 [37]. Indiscriminate use of fluoroquinolones is seen in Pakistan for many febrile illnesses [38], with resistance to a number of organisms increasing as well [39,40].…”

Section: Discussionmentioning

confidence: 73%

A three-year review of antimicrobial resistance of Salmonella enterica serovars Typhi and Paratyphi A in Pakistan

Qamar

Azmatullah

Kazi

et al. 2014

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Enteric fever is among the most common bacteraemic illnesses in South Asia. Multidrug resistance as well as fluoroquinolone resistance has severely limited therapeutic options in high disease burden countries such as Pakistan. This review was conducted to determine the frequency of drug-resistant Salmonella enterica serovar Typhi (S.Typhi) and Salmonella enterica serovar Paratyphi A (S. Paratyphi A) between2009 and 2011. Methodology: This study was a review of laboratory data. The antibiotic susceptibility of typhoidal Salmonellae isolated from blood cultures submitted to the Aga Khan University Hospital's laboratory from all over Pakistan between January 2009 and December 2011 were reviewed. Results: The sensitivity data of 4,323 positive isolates of S. Typhi and S. Paratyphi A isolated during the three-year period were reviewed. The majority of isolates were S. Typhi (59.6%).Over three years, the incidence of multidrug-resistant (MDR) S.Typhi remained high, ranging from 64.8%-66.0%, while MDR S. Paratyphi A decreased from 4.2% to 0.6%.Fluoroquinolone resistance increased for S. Typhi from 84.7% to 91.7%.Cefixime-and ceftriaxone-resistant S. Typhi were isolated in two children. Conclusions: Our results show high rates of multidrug and fluoroquinolone resistance among S. Typhi and S. Paratyphi. The occurrence of two cases of ceftriaxone resistance is alarming.

show abstract

Section: Discussionmentioning

confidence: 73%

A three-year review of antimicrobial resistance of Salmonella enterica serovars Typhi and Paratyphi A in Pakistan

Qamar

Azmatullah

Kazi

et al. 2014

J Infect Dev Ctries

View full text Add to dashboard Cite

show abstract

“…<12 months) in hospital [13] and community based studies [14]. This has not been an invariant finding [15] and vertical transmission to neonates from carrier mothers have been reported [16], [17] so in principle, neonates in at least some populations are susceptible. The period of this lower incidence appears highly variable between different sites.…”

Section: Modelmentioning

confidence: 97%

Stochastic Simulation of Endemic Salmonella enterica Serovar Typhi: The Importance of Long Lasting Immunity and the Carrier State

2013

View full text Add to dashboard Cite

BackgroundTyphoid fever caused by Salmonella enterica serovar Typhi (S. Typhi) remains a serious burden of disease, especially in developing countries of Asia and Africa. It is estimated that it causes 200,000 deaths per year, mainly in children. S. Typhi is an obligate pathogen of humans and although it has a relatively complex life cycle with a long lived carrier state, the absence of non-human hosts suggests that well targeted control methods should have a major impact on disease. Newer control methods including new generations of vaccines offer hope but their implementation would benefit from quantitative models to guide the most cost effective strategies. This paper presents a quantitative model of Typhoid disease, immunity and transmission as a first step in that process.Methodology/Principal FindingsA stochastic agent-based model has been developed that incorporates known features of the biology of typhoid including probability of infection, the consequences of infection, treatment options, acquisition and loss of immunity as a result of infection and vaccination, the development of the carrier state and the impact of environmental or behavioral factors on transmission. The model has been parameterized with values derived where possible from the literature and where this was not possible, feasible parameters space has been determined by sensitivity analyses, fitting the simulations to age distribution of field data. The model is able to adequately predict the age distribution of typhoid in two settings.Conclusions/SignificanceThe modeling highlights the importance of variations in the exposure/resistance of infants and young children to infection in different settings, especially as this impacts on design of control programs; it predicts that naturally induced clinical and sterile immunity to typhoid is long lived and highlights the importance of the carrier state especially in areas of low transmission.

show abstract

“…The incidence estimates reported from pediatric population-based studies (51–76 cases/100,000 person-years) did not differ substantially from incidence reported in adults and children from South Asian countries [23], [24]. In all pediatric studies, S. Paratyphi A accounted for a lower proportion of enteric fever cases (8.6–17.0%) than in studies which included adults, with the exception of one study conducted in New Delhi, India [23]–[27].…”

Section: Resultsmentioning

confidence: 74%

Estimating the Burden of Paratyphoid A in Asia and Africa

et al. 2014

View full text Add to dashboard Cite

Despite the increasing availability of typhoid vaccine in many regions, global estimates of mortality attributable to enteric fever appear stable. While both Salmonella enterica serovar Typhi (S. Typhi) and serovar Paratyphi (S. Paratyphi) cause enteric fever, limited data exist estimating the burden of S. Paratyphi, particularly in Asia and Africa.We performed a systematic review of both English and Chinese-language databases to estimate the regional burden of paratyphoid within Africa and Asia. Distinct from previous reviews of the topic, we have presented two separate measures of burden; both incidence and proportion of enteric fever attributable to paratyphoid. Included articles reported laboratory-confirmed Salmonella serovar classification, provided clear methods on sampling strategy, defined the age range of participants, and specified the time period of the study.A total of 64 full-text articles satisfied inclusion criteria and were included in the qualitative synthesis. Paratyphoid A was commonly identified as a cause of enteric fever throughout Asia. The highest incidence estimates in Asia came from China; four studies estimated incidence rates of over 150 cases/100,000 person-years. Paratyphoid A burden estimates from Africa were extremely limited and with the exception of Nigeria, few population or hospital-based studies from Africa reported significant Paratyphoid A burden.While significant gaps exist in the existing population-level estimates of paratyphoid burden in Asia and Africa, available data suggest that paratyphoid A is a significant cause of enteric fever in Asia. The high variability in documented incidence and proportion estimates of paratyphoid suggest considerable geospatial variability in the burden of paratyphoid fever. Additional efforts to monitor enteric fever at the population level will be necessary in order to accurately quantify the public health threat posed by S. Paratyphi A, and to improve the prevention and treatment of enteric fever.

show abstract

Incidence of Typhoid Bacteremia in Infants and Young Children in Southern Coastal Pakistan

Cited by 55 publications

References 23 publications

A three-year review of antimicrobial resistance of Salmonella enterica serovars Typhi and Paratyphi A in Pakistan

A three-year review of antimicrobial resistance of Salmonella enterica serovars Typhi and Paratyphi A in Pakistan

Stochastic Simulation of Endemic Salmonella enterica Serovar Typhi: The Importance of Long Lasting Immunity and the Carrier State

Estimating the Burden of Paratyphoid A in Asia and Africa

Contact Info

Product

Resources

About