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­čÜĘTyphoid Fever on the Rise: Urgent Action Needed in India

21 Apr 2023 ÔÇó Typhoid fever is a significant public health issue in India, with more than half of the cases worldwide occurring in the country in 2017. However, it is unclear whether the declining trends in hospitalizations for typhoid in India reflect increased antibiotic treatment or a true reduction in infection. To address this question, a study was conducted from 2017 to 2020, which included weekly surveillance for acute febrile illness and measured the incidence of typhoid fever in a prospective cohort of children aged 6 months to 14 years at urban and rural sites in India.

The study found that the incidence of typhoid fever remains high in urban areas, with an incidence per 100,000 child-years of 576 to 1173 cases in urban sites and 35 in rural Pune. In contrast, the estimated incidence of typhoid fever from hospital surveillance ranged from 12 to 1622 cases per 100,000 child-years among children aged 6 months to 14 years and from 108 to 970 cases per 100,000 person-years among those who were 15 years of age or older.

The study also found that Salmonella enterica serovar Paratyphi was isolated from 33 children, for an overall incidence of 68 cases per 100,000 child-years after adjustment for age. These findings suggest that the incidence of typhoid fever in urban India remains high, while estimates of incidence in most rural areas are generally lower. The study highlights the need for continued efforts to improve access to effective antibiotics and sanitation measures in India to reduce the burden of typhoid fever.

Source: NEJM | Read full story

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