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Tenacious Endemic Typhoid Fever in Samoa.

Michael J Sikorski1,2, Sachin N Desai1,2, Siaosi Tupua2

  • 1Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|July 30, 2020
PubMed
Summary

Typhoid fever remains endemic in Samoa, with most cases occurring in individuals under 50 years old. Public health interventions, including vaccination, are planned to combat this persistent infectious disease.

Keywords:
Salmonella TyphiOceaniaSamoaepidemiologytyphoid fever

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Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Typhoid fever has been endemic in Samoa since the 1960s, persisting through 2019 despite development.
  • The study examines typhoid fever trends in Samoa from 2008 to 2019.

Purpose of the Study:

  • To describe the burden and incidence of typhoid fever in Samoa.
  • To analyze typhoid fever cases by time, place, and person.

Main Methods:

  • Analysis of blood culture-confirmed Salmonella enterica serovar Typhi isolates and patient data from 2008-2019.
  • Utilized census data and projections for incidence calculations by geographic region.
  • Descriptive analysis of case burden and incidence.

Main Results:

  • Annual typhoid cases ranged from 53-193 between 2008-2019, with no clear seasonality.
  • Highest incidence observed in individuals aged 5-34 years, with 93.6% of cases in Samoans under 50.
  • Northwest Upolu had the most cases and highest incidence; Apia Urban Area also showed moderate incidence.

Conclusions:

  • Typhoid fever remains endemic in Samoa during the study period.
  • Samoan Salmonella Typhi isolates are pansusceptible to first-line antibiotics.
  • Planned interventions include mass vaccination with a Vi-conjugate vaccine.