Burden of typhoid fever in low-income and middle-income countries: a systematic, literature-based update with risk-factor adjus
Burden of typhoid fever in low-
income and middle-income countries:
a systematic, literature-based update
with risk-factor adjustment
Access to safe water and sanitation is inadequate in many parts of the world. The scarcity of these basic amenities weighs heavily on public health, and typhoid fever—a severe life-threatening illness caused by Salmonella serovar Typhi—is one of the many unfortunate consequences.
Several efforts have been made to estimate the global burden of typhoid fever.1—5 Crump and colleagues2 estimated 21·6 million cases (range 10·8—43·3 million) in the year 2000 with the highest incidence in children in south and southeast Asia. Buckle and colleagues3 later estimated 13·9—26·9 million cases worldwide for 2010. Although, these estimates provide a broad measure of the typhoid burden, approaches that distinguish the risk differences by population groups within countries are necessary. WHO's typhoid position paper6 suggested targeting of high-risk populations for polysaccharide vaccination.6, 7Therefore, strategies for typhoid conjugate vaccination need to appraise the consequences of targeting high-risk populations as opposed to universal vaccination…