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Typhoid fever in Bangladesh: implications for vaccination policy
1Bangaldesh Institute of Child Health, Dhaka Shishu Children Hospital, Dhaka. sksaha@bangla.net
The Pediatric Infectious Disease Journal
|May 23, 2001
Summary
Typhoid fever (Salmonella typhi bacteremia) is significantly more common in children under 5 in Bangladesh than previously thought. The highest rates were observed in children aged 2 years, suggesting a need for infant-targeted vaccines.
Area of Science:
- Infectious Diseases
- Bacteriology
- Public Health
Background:
- Typhoid fever is a significant public health concern in endemic regions.
- Accurate age-specific epidemiological data are crucial for effective disease control and vaccine development.
Purpose of the Study:
- To determine the age-specific prevalence of Salmonella typhi bacteremia.
- To quantify the bacterial load in blood across different age groups.
- To inform public health strategies and vaccine recommendations in Bangladesh.
Main Methods:
- A prospective, laboratory-based study was conducted over 16 months in Dhaka, Bangladesh.
- Blood cultures were analyzed from 4,650 patients presenting to private clinics and hospitals.
- Salmonella typhi isolation and quantification used the lysis direct plating/centrifugation method.
Main Results:
- Salmonella typhi was the most common pathogen (72.7%), identified in 391 of 538 positive blood cultures.
- The majority of S. typhi isolates (54.5%) were from children under 5 years old.
- Bacteremia rates peaked in the second year of life (17.4%), with bacterial load inversely related to age.
Conclusions:
- Typhoid fever detection is substantially higher in young children (< or =2 years) than previously recognized in Dhaka.
- Current typhoid fever vaccine recommendations may need reassessment to target infants and young children.
- Regional assessments of age-specific typhoid burden are necessary.