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Article: Spatial Heterogeneity of Enteric Fever in 2 Diverse Communities in Nepal

TitleSpatial Heterogeneity of Enteric Fever in 2 Diverse Communities in Nepal
Authors
Keywordsenteric fever
geospatial
Nepal
Salmonella
typhoid
Issue Date2020
Citation
Clinical Infectious Diseases, 2020, v. 71, p. S205-S213 How to Cite?
AbstractBackground: Typhoid fever is endemic in the urban Kathmandu Valley of Nepal; however, there have been no population-based studies of typhoid outside of this community in the past 3 decades. Whether typhoid immunization should be prioritized in periurban and rural communities has been unclear. Methods: We performed population-based surveillance for enteric fever in 1 urban catchment (Kathmandu) and 1 periurban and rural catchment (Kavrepalanchok) as part of the Surveillance for Enteric Fever in Asia Project (SEAP). We recruited individuals presenting to outpatient and emergency departments at 2 study hospitals with suspected enteric fever and performed blood cultures. Additionally, we conducted a household survey in each catchment area to characterize care seeking for febrile illness. We evaluated spatial heterogeneity in febrile illness, care seeking, and enteric fever incidence. Results: Between September 2016 and September 2019, we enrolled 5736 participants with suspected enteric fever at 2 study hospitals. Among these, 304 (5.3%) were culture positive for Salmonella Typhi (249 [81.9%]) or Paratyphi A (55 [18.1%]). Adjusted typhoid incidence in Kathmandu was 484 per 100 000 person-years and in Kavrepalanchok was 615 per 100 000 person-years. While all geographic areas for which estimates could be made had incidence >200 per 100 000 person-years, we observed spatial heterogeneity with up to 10-fold variation in incidence between communities. Conclusions: In urban, periurban, and rural communities in and around Kathmandu, we measured a high but heterogenous incidence of typhoid. These findings provide some support for the introduction of conjugate vaccines in Nepal, including outside urban areas, alongside other measures to prevent enteric fever.
Persistent Identifierhttp://hdl.handle.net/10722/319054
ISSN
2023 Impact Factor: 8.2
2023 SCImago Journal Rankings: 3.308
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTamrakar, Dipesh-
dc.contributor.authorVaidya, Krista-
dc.contributor.authorYu, Alexander T.-
dc.contributor.authorAiemjoy, Kristen-
dc.contributor.authorNaga, Shiva Ram-
dc.contributor.authorCao, Yanjia-
dc.contributor.authorBern, Caryn-
dc.contributor.authorShrestha, Rajeev-
dc.contributor.authorKarmacharya, Biraj M.-
dc.contributor.authorPradhan, Sailesh-
dc.contributor.authorQamar, Farah Naz-
dc.contributor.authorSaha, Samir-
dc.contributor.authorDate, Kashmira-
dc.contributor.authorLongley, Ashley T.-
dc.contributor.authorHemlock, Caitlin-
dc.contributor.authorLuby, Stephen-
dc.contributor.authorGarrett, Denise O.-
dc.contributor.authorBogoch, Isaac I.-
dc.contributor.authorAndrews, Jason R.-
dc.date.accessioned2022-10-11T12:25:10Z-
dc.date.available2022-10-11T12:25:10Z-
dc.date.issued2020-
dc.identifier.citationClinical Infectious Diseases, 2020, v. 71, p. S205-S213-
dc.identifier.issn1058-4838-
dc.identifier.urihttp://hdl.handle.net/10722/319054-
dc.description.abstractBackground: Typhoid fever is endemic in the urban Kathmandu Valley of Nepal; however, there have been no population-based studies of typhoid outside of this community in the past 3 decades. Whether typhoid immunization should be prioritized in periurban and rural communities has been unclear. Methods: We performed population-based surveillance for enteric fever in 1 urban catchment (Kathmandu) and 1 periurban and rural catchment (Kavrepalanchok) as part of the Surveillance for Enteric Fever in Asia Project (SEAP). We recruited individuals presenting to outpatient and emergency departments at 2 study hospitals with suspected enteric fever and performed blood cultures. Additionally, we conducted a household survey in each catchment area to characterize care seeking for febrile illness. We evaluated spatial heterogeneity in febrile illness, care seeking, and enteric fever incidence. Results: Between September 2016 and September 2019, we enrolled 5736 participants with suspected enteric fever at 2 study hospitals. Among these, 304 (5.3%) were culture positive for Salmonella Typhi (249 [81.9%]) or Paratyphi A (55 [18.1%]). Adjusted typhoid incidence in Kathmandu was 484 per 100 000 person-years and in Kavrepalanchok was 615 per 100 000 person-years. While all geographic areas for which estimates could be made had incidence >200 per 100 000 person-years, we observed spatial heterogeneity with up to 10-fold variation in incidence between communities. Conclusions: In urban, periurban, and rural communities in and around Kathmandu, we measured a high but heterogenous incidence of typhoid. These findings provide some support for the introduction of conjugate vaccines in Nepal, including outside urban areas, alongside other measures to prevent enteric fever.-
dc.languageeng-
dc.relation.ispartofClinical Infectious Diseases-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectenteric fever-
dc.subjectgeospatial-
dc.subjectNepal-
dc.subjectSalmonella-
dc.subjecttyphoid-
dc.titleSpatial Heterogeneity of Enteric Fever in 2 Diverse Communities in Nepal-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1093/cid/ciaa1319-
dc.identifier.pmid33258932-
dc.identifier.pmcidPMC7705881-
dc.identifier.scopuseid_2-s2.0-85097036416-
dc.identifier.volume71-
dc.identifier.spageS205-
dc.identifier.epageS213-
dc.identifier.eissn1537-6591-
dc.identifier.isiWOS:000605984900003-

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