The Burden of Typhoid Fever in Sub-Saharan Africa: A Perspective

Kim, Cara Lynn; Espinoza, Ligia María Cruz; Vannice, Kirsten; Tadesse, Birkneh Tilahun; Owusu‐Dabo, Ellis; Rakotozandrindrainy, Raphäel; Jani, Ilesh; Teferi, Mekonnen; Soura, Abdramane; Lunguya, Octavie; Steele, A. Duncan; Marks, Florian

doi:10.2147/rrtm.s282461

Cited by 23 publications

(22 citation statements)

References 77 publications

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“…The method uses standard microbiological laboratory infrastructure and techniques to detect Typhi-specific bacteriophages. Environmental phage surveillance can be used to estimate typhoid in other countries, including in Sub-Saharan Africa where limited epidemiological data on typhoid fever is available (Carey and Steele, 2019; Kim et al, 2022). Environmental phage surveillance may be also applied to map routes of disease transmission by focusing on wastewater/sewage facilities in the region.…”

Section: Discussionmentioning

confidence: 99%

Old tools, new applications: use of environmental bacteriophages for typhoid surveillance and evaluating vaccine impact

Hooda

Islam

Kabiraj

et al. 2023

Preprint

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Typhoid-conjugate vaccines (TCVs) provide an opportunity to reduce the burden of typhoid fever, caused by Salmonella Typhi, in endemic areas. As policymakers design vaccination strategies, accurate and high-resolution data on disease burden is crucial. However, traditional blood culture-based surveillance is resource-extensive, prohibiting its large-scale and sustainable implementation. Salmonella Typhi is a water-borne pathogen, and here, we tested the potential of Typhi-specific bacteriophage surveillance in surface water bodies as a low-cost tool to identify where Salmonella Typhi circulates in the environment. In 2021, water samples were collected and tested for the presence of Salmonella Typhi bacteriophages at two sites in Bangladesh: urban capital city, Dhaka, and a rural district, Mirzapur. Salmonella Typhi-specific bacteriophages were detected in 66 of 211 (31%) environmental samples in Dhaka, in comparison to 3 of 92 (3%) environmental samples from Mirzapur. In the same year, 4,620 blood cultures at the two largest pediatric hospitals of Dhaka yielded 215 (5%) culture-confirmed typhoid cases, and 3,788 blood cultures in the largest hospital of Mirzapur yielded 2 (0.05%) cases. 75% (52/69) of positive phage samples were collected from sewage. All isolated phages were tested against a panel of isolates from different Salmonella Typhi genotypes circulating in Bangladesh and were found to exhibit a diverse killing spectrum, indicating diverse bacteriophages were isolated. These results suggest an association between the presence of Typhi-specific phages in the environment and the burden of typhoid fever, and the potential of utilizing environmental phage surveillance as a low-cost tool to assist policy decisions on typhoid control.

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Section: Discussionmentioning

confidence: 99%

Old tools, new applications: use of environmental bacteriophages for typhoid surveillance and evaluating vaccine impact

Hooda

Islam

Kabiraj

et al. 2023

Preprint

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“…Since the data collected by EF are from significant outbreaks, the global incidence of EF reports is more of an estimate. Because of the shortage of diagnostic facilities and effective surveillance technologies in many developing nations, predominantly in sub-Saharan Africa, the prevalence of EF is poorly characterized [123].…”

Section: Epidemiology Of Enteric Fevermentioning

confidence: 99%

Human Salmonellosis: A Continuous Global Threat in the Farm-to-Fork Food Safety Continuum

Al-Hindi

Albiheyri

Alharbi

et al. 2023

Foods

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Salmonella is one of the most common zoonotic foodborne pathogens and a worldwide public health threat. Salmonella enterica is the most pathogenic among Salmonella species, comprising over 2500 serovars. It causes typhoid fever and gastroenteritis, and the serovars responsible for the later disease are known as non-typhoidal Salmonella (NTS). Salmonella transmission to humans happens along the farm-to-fork continuum via contaminated animal- and plant-derived foods, including poultry, eggs, fish, pork, beef, vegetables, fruits, nuts, and flour. Several virulence factors have been recognized to play a vital role in attaching, invading, and evading the host defense system. These factors include capsule, adhesion proteins, flagella, plasmids, and type III secretion systems that are encoded on the Salmonella pathogenicity islands. The increased global prevalence of NTS serovars in recent years indicates that the control approaches centered on alleviating the food animals’ contamination along the food chain have been unsuccessful. Moreover, the emergence of antibiotic-resistant Salmonella variants suggests a potential food safety crisis. This review summarizes the current state of the knowledge on the nomenclature, microbiological features, virulence factors, and the mechanism of antimicrobial resistance of Salmonella. Furthermore, it provides insights into the pathogenesis and epidemiology of Salmonella infections. The recent outbreaks of salmonellosis reported in different clinical settings and geographical regions, including Africa, the Middle East and North Africa, Latin America, Europe, and the USA in the farm-to-fork continuum, are also highlighted.

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“…Although the exact burden of infectious diseases caused by enteric bacteria in Sub-Saharan Africa is vague, recent reports have shown an increase in the prevalence of diseases caused by enteric bacteria, such as sepsis and typhoid (5), cholera (6), shigellosis (7), and diarrhoeal infection (8). Antimicrobial resistance (AMR) has been established to be a significant driver for the persistence and spread of these diseases, particularly in cases where the causative agents are multidrug-resistant (MDR) or extensively drug-resistant (XDR) (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Genomic Characterisation of Multidrug-Resistant Pathogenic Enteric Bacteria from healthy children in Osun State, Nigeria

Uwanibe

Olawoye

Happi

et al. 2023

Preprint

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Antimicrobial resistance (AMR) has been established to be a significant driver for the persistence and spread of bacterial infections. It is, therefore, essential to conduct epidemiological surveillance of AMR in healthy individuals to understand the actual dynamics of AMR in Nigeria. Multi-drug resistant Klebsiella quasivariicola (n=1), Enterobacter hormaechei (n=1), and Escherichia coli (n=3) from stool samples of healthy children were subjected to whole genome sequencing using Illumina Nextseq1000/2000 and Oxford nanopore. Bioinformatics analysis reveals antimicrobial resistance, virulence genes, and plasmids. This pathogenic enteric bacteria harbored more than three plasmid replicons of either Col and/or Inc type associated with outbreaks and AMR resistant gene pmrB responsible for colistin resistance. Plasmid reconstruction revealed an integrated tetA gene responsible for tetracycline resistance, and caa gene responsible for toxin production in two of the E.coli isolates, and a cusC gene known to induce neonatal meningitis in the K. quasivariicola ST3879. The global spread of MDR pathogenic enteric bacteria is a worrying phenomenon, and close surveillance of healthy individuals, especially children, is strongly recommended to prevent the continuous spread and achieve the elimination and eradication of these infections. Molecular epidemiological surveillance using whole genome sequencing (WGS) will improve the detection of MDR pathogens in Nigeria.

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The Burden of Typhoid Fever in Sub-Saharan Africa: A Perspective

Cited by 23 publications

References 77 publications

Old tools, new applications: use of environmental bacteriophages for typhoid surveillance and evaluating vaccine impact

Old tools, new applications: use of environmental bacteriophages for typhoid surveillance and evaluating vaccine impact

Human Salmonellosis: A Continuous Global Threat in the Farm-to-Fork Food Safety Continuum

Genomic Characterisation of Multidrug-Resistant Pathogenic Enteric Bacteria from healthy children in Osun State, Nigeria

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