IVI and South Africa
From 2010 to 2014, IVI’s The Typhoid Fever Surveillance in Africa Program (TSAP) obtained comparable incidence data on typhoid fever and invasive nontyphoidal Salmonella (iNTS) disease in sub-Saharan Africa through standardized surveillance in ten countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania).
In South Africa, TSAP ran from 2012 to 2014, conducting surveillance in the Pietermaritzburg area in collaboration with the National Institute for Communicable Diseases, a division of the National Health Laboratory Service located in Johannesburg, which provided supplemental laboratory and technical support and the management of specimens.
Each TSAP site conducted passive surveillance for bloodstream infections among febrile patients to isolate and identify aerobic bacteria from the patients’ blood. Healthcare utilization surveys were conducted to adjust population denominators in incidence calculations for differing healthcare utilization patterns and improve comparability of incidence rates across sites. The results of TSAP indicated that enteric fever caused by Salmonella Typhi and non-typhoidal Salmonella are significant problems in Africa and that the prevalence of multi-drug resistance may limit appropriate treatment options.
Along with its new disease burden discoveries, TSAP and its collaborators strengthened local surveillance capacities at multiple sites across sub-Saharan Africa, creating a system that has improved bacterial disease diagnostics, disease surveillance, reporting, and analysis systems in the region.