ArticlePloS one2016
Typhoid Fever in South Africa in an Endemic HIV Setting.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Case Fatality Rate of Enteric Fever in Endemic Countries: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Pooled it
- Epidemiologic trends, diagnostic limitations, and public health challenges of enteric fever in sub-Saharan Africa: A narrative review.IJID regions · 2026Review
- Assessing Salmonella Typhi Pathogenicity and Prevention: The Crucial Role of Vaccination in Combating Typhoid Fever.International journal of molecular sciences · 2025Review
- Pericardial Abscess Due to Salmonella Typhi Infection.The American journal of tropical medicine and hygiene · 2025Article
- Prevalence of typhoid fever and its associated factors among febrile patients visiting Arerti Primary Hospital, Amhara Region, north east Ethiopia.Frontiers in public health · 2024Article
- Article
- Enteric fever.BMJ (Clinical research ed.) · 2021Article
- Ascertaining the burden of invasive Salmonella disease in hospitalised febrile children aged under four years in Blantyre, Malawi.PLoS neglected tropical diseases · 2019Article
- Health Considerations for HIV-Infected International Travelers.Current infectious disease reports · 2019Review
- The phylogeography and incidence of multi-drug resistant typhoid fever in sub-Saharan Africa.Nature communications · 2018Article
- Comparison of Strategies and Incidence Thresholds for Vi Conjugate Vaccines Against Typhoid Fever: A Cost-effectiveness Modeling Study.The Journal of infectious diseases · 2018Article
- The Burden of Typhoid Fever in South Africa: The Potential Impact of Selected Interventions.The American journal of tropical medicine and hygiene · 2018Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundTyphoid fever remains an important disease in Africa, associated with outbreaks and the emerging multidrug resistant Salmonella enterica serotype Typhi (Salmonella Typhi) haplotype, H58. This study describes the incidence of, and factors associated with mortality due to, typhoid fever in South Africa, where HIV prevalence is high. METHODS AND
findingsNationwide active laboratory-based surveillance for culture-confirmed typhoid fever was undertaken from 2003-2013. At selected institutions, additional clinical data from patients were collected including age, sex, HIV status, disease severity and outcome. HIV prevalence among typhoid fever patients was compared to national HIV seroprevalence estimates. The national reference laboratory tested Salmonella Typhi isolates for antimicrobial susceptibility and haplotype. Unadjusted and adjusted logistic regression analyses were conducted determining factors associated with typhoid fever mortality. We identified 855 typhoid fever cases: annual incidence ranged from 0.11 to 0.39 per 100,000 population. Additional clinical data were available for 369 (46.8%) cases presenting to the selected sites. Among typhoid fever patients with known HIV status, 19.3% (29/150) were HIV-infected. In adult females, HIV prevalence in typhoid fever patients was 43.2% (19/44) versus 15.7% national HIV seroprevalence (P < .001); in adult males, 16.3% (7/43) versus 12.3% national HIV seroprevalence (P = .2). H58 represented 11.9% (22/185) of Salmonella Typhi isolates tested. Increased mortality was associated with HIV infection (AOR 10.7; 95% CI 2.3-50.3) and disease severity (AOR 9.8; 95% CI 1.6-60.0) on multivariate analysis.
conclusionsTyphoid fever incidence in South Africa was largely unchanged from 2003-2013. Typhoid fever mortality was associated disease severity. HIV infection may be a contributing factor. Interventions mandate improved health care access, including to HIV management programmes as well as patient education. Further studies are necessary to clarify relationships between HIV infection and typhoid fever in adults.
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