TY - JOUR
T1 - Geographic Pattern of Typhoid Fever in India
T2 - A Model-Based Estimate of Cohort and Surveillance Data
AU - Cao, Yanjia
AU - Karthikeyan, Arun S.
AU - Ramanujam, Karthikeyan
AU - Raju, Reshma
AU - Krishna, Swathi
AU - Kumar, Dilesh
AU - Ryckman, Theresa
AU - Mohan, Venkata Raghava
AU - Kang, Gagandeep
AU - John, Jacob
AU - Andrews, Jason R.
AU - Lo, Nathan C.
PY - 2021/11/23
Y1 - 2021/11/23
N2 - BACKGROUND: Typhoid fever remains a major public health problem in India. Recently, the Surveillance for Enteric Fever in India program completed a multisite surveillance study. However, data on subnational variation in typhoid fever are needed to guide the introduction of the new typhoid conjugate vaccine in India. METHODS: We applied a geospatial statistical model to estimate typhoid fever incidence across India, using data from 4 cohort studies and 6 hybrid surveillance sites from October 2017 to March 2020. We collected geocoded data from the Demographic and Health Survey in India as predictors of typhoid fever incidence. We used a log linear regression model to predict a primary outcome of typhoid incidence. RESULTS: We estimated a national incidence of typhoid fever in India of 360 cases (95% confidence interval [CI], 297-494) per 100 000 person-years, with an annual estimate of 4.5 million cases (95% CI, 3.7-6.1 million) and 8930 deaths (95% CI, 7360-12 260), assuming a 0.2% case-fatality rate. We found substantial geographic variation of typhoid incidence across the country, with higher incidence in southwestern states and urban centers in the north. CONCLUSIONS: There is a large burden of typhoid fever in India with substantial heterogeneity across the country, with higher burden in urban centers.
AB - BACKGROUND: Typhoid fever remains a major public health problem in India. Recently, the Surveillance for Enteric Fever in India program completed a multisite surveillance study. However, data on subnational variation in typhoid fever are needed to guide the introduction of the new typhoid conjugate vaccine in India. METHODS: We applied a geospatial statistical model to estimate typhoid fever incidence across India, using data from 4 cohort studies and 6 hybrid surveillance sites from October 2017 to March 2020. We collected geocoded data from the Demographic and Health Survey in India as predictors of typhoid fever incidence. We used a log linear regression model to predict a primary outcome of typhoid incidence. RESULTS: We estimated a national incidence of typhoid fever in India of 360 cases (95% confidence interval [CI], 297-494) per 100 000 person-years, with an annual estimate of 4.5 million cases (95% CI, 3.7-6.1 million) and 8930 deaths (95% CI, 7360-12 260), assuming a 0.2% case-fatality rate. We found substantial geographic variation of typhoid incidence across the country, with higher incidence in southwestern states and urban centers in the north. CONCLUSIONS: There is a large burden of typhoid fever in India with substantial heterogeneity across the country, with higher burden in urban centers.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85125613165&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/35238365
U2 - https://doi.org/10.1093/infdis/jiab187
DO - https://doi.org/10.1093/infdis/jiab187
M3 - Article
C2 - 35238365
SN - 0022-1899
VL - 224
SP - S475-S483
JO - Journal of infectious diseases
JF - Journal of infectious diseases
IS - 5
ER -