SynthesisThe Lancet. Infectious diseases2019
The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017.
Synthesis in The Lancet. Infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 446 papers, 8 of them syntheses that pooled it.
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446 citing papers in PubMed, 8 syntheses or guidelines pooled it, 825 citations in OpenAlex.
- Burden of antimicrobial resistance in culture-confirmed Salmonella Typhi isolates in India from 1977 to 2024: A systematic review and meta-analysis.PLoS neglected tropical diseases · 2026Pooled it
- Risk Factors for Typhoid Fever: Systematic Review.JMIR public health and surveillance · 2025Pooled it
- Length of hospital stay and associated treatment costs for patients with susceptible and antibiotic-resistantBMJ open · 2025Pooled it
- Typhoid conjugate vaccines for preventing typhoid fever (enteric fever).The Cochrane database of systematic reviews · 2025Pooled it
- Nationwide trends and features of human salmonellosis outbreaks in China.Emerging microbes & infections · 2024Pooled it
- Enteric Fever-Associated Hemophagocytic Lymphohistiocytosis: A Systematic Review of Clinical Characteristics and Outcomes.The American journal of tropical medicine and hygiene · 2024Pooled it
- Pooled it
- Associations of water, sanitation, and hygiene with typhoid fever in case-control studies: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- Co-administration of oral killed whole-cell recombinant cholera toxin B-subunit vaccine (WC-rCTB) and live Salmonella Typhi Ty21a vaccine: a prospective randomized open-label trial.Journal of travel medicine · 2026Trial
- Comparative immune response of Typbar TCV® (typhoid conjugate vaccine) in extremes of age: An Indian experience.Human vaccines & immunotherapeutics · 2025Trial
- Trial
- The validity of test-negative design for assessment of typhoid conjugate vaccine protection: comparison of estimates by different study designs using data from a cluster-randomised controlled trial.The Lancet. Global health · 2025Trial
- Safety and immunogenicity of conjugate vaccine for typhoid (Vi-DT): Finding from an observer-blind, active-controlled, randomized, non-inferiority, phase III clinical trial among healthy volunteers.Human vaccines & immunotherapeutics · 2024Trial
- Molecular correlates of vaccine-induced protection against typhoid fever.The Journal of clinical investigation · 2023Trial
- An observer-blinded, cluster randomised trial of a typhoid conjugate vaccine in an urban South Indian cohort.Trials · 2023Trial
- Development and validation of immunological assays for preclinical evaluation of a novel bivalent typhoid conjugate vaccine.Human vaccines & immunotherapeutics · 2026Article
- A case for eliminating Widal testing for enteric fever, India.Bulletin of the World Health Organization · 2026Article
- Azithromycin-resistantJAC-antimicrobial resistance · 2026Article
- Genomic Detection of Multidrug-Resistant H58 ST1 Salmonella Typhi in a South African Urban Waterway Reveals Epidemiological Links With Clinical Isolates.MicrobiologyOpen · 2026Article
- Article
386 more citing papers are in PubMed but not listed here.
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Abstract
backgroundEfforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, and the approach taken to produce them.
methodsFor this systematic analysis we broke down the relative contributions of typhoid and paratyphoid fevers by country, year, and age, and analysed trends in incidence and mortality. We modelled the combined incidence of typhoid and paratyphoid fevers and split these total cases proportionally between typhoid and paratyphoid fevers using aetiological proportion models. We estimated deaths using vital registration data for countries with sufficiently high data completeness and using a natural history approach for other locations. We also estimated disability-adjusted life-years (DALYs) for typhoid and paratyphoid fevers.
findingsGlobally, 14·3 million (95% uncertainty interval [UI] 12·5-16·3) cases of typhoid and paratyphoid fevers occurred in 2017, a 44·6% (42·2-47·0) decline from 25·9 million (22·0-29·9) in 1990. Age-standardised incidence rates declined by 54·9% (53·4-56·5), from 439·2 (376·7-507·7) per 100 000 person-years in 1990, to 197·8 (172·0-226·2) per 100 000 person-years in 2017. In 2017, Salmonella enterica serotype Typhi caused 76·3% (71·8-80·5) of cases of enteric fever. We estimated a global case fatality of 0·95% (0·54-1·53) in 2017, with higher case fatality estimates among children and older adults, and among those living in lower-income countries. We therefore estimated 135·9 thousand (76·9-218·9) deaths from typhoid and paratyphoid fever globally in 2017, a 41·0% (33·6-48·3) decline from 230·5 thousand (131·2-372·6) in 1990. Overall, typhoid and paratyphoid fevers were responsible for 9·8 million (5·6-15·8) DALYs in 2017, down 43·0% (35·5-50·6) from 17·2 million (9·9-27·8) DALYs in 1990.
interpretationDespite notable progress, typhoid and paratyphoid fevers remain major causes of disability and death, with billions of people likely to be exposed to the pathogens. Although improvements in water and sanitation remain essential, increased vaccine use (including with typhoid conjugate vaccines that are effective in infants and young children and protective for longer periods) and improved data and surveillance to inform vaccine rollout are likely to drive the greatest improvements in the global burden of the disease.
fundingBill & Melinda Gates Foundation.
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