ArticlePLoS neglected tropical diseases2020
Under-detection of blood culture-positive enteric fever cases: The impact of missing data and methods for adjusting incidence estimates.
Article in PLoS neglected tropical diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 29 citations in OpenAlex.
- Efficacy of typhoid conjugate vaccine in Nepal: final results of a phase 3, randomised, controlled trial.The Lancet. Global health · 2021Trial
- Strengthening the Reporting of Observational Studies in Epidemiology Enhanced Prevalence and Incidence Criteria (STROBE EPIC): An Extension of the STROBE Statement.Annals of internal medicine · 2026Article
- Estimating Enteric Fever Seroincidence in Bangladesh Using Rapid Serosurveys.Open forum infectious diseases · 2026Article
- Estimating enteric fever seroincidence in Bangladesh using rapid serosurveys.medRxiv : the preprint server for health sciences · 2026Article
- Leveraging paired serology to estimate the incidence of typhoidal Salmonella infection in the STRATAA study.PLoS neglected tropical diseases · 2025Article
- Spatial heterogeneity of socio-economic determinants of typhoid/paratyphoid fever in one province in central China from 2015 to 2019.BMC public health · 2023Article
- Taking on Typhoid: Eliminating Typhoid Fever as a Global Health Problem.Open forum infectious diseases · 2023Article
- Seroincidence of Enteric Fever, Juba, South Sudan.Emerging infectious diseases · 2022Article
- Factors Predicting Blood Culture Positivity in Children With Enteric Fever.The Journal of infectious diseases · 2021Article
- Incidence of Enteric Fever in a Pediatric Cohort in North India: Comparison with Estimates from 20 Years Earlier.The Journal of infectious diseases · 2021Article
- A Bayesian approach for estimating typhoid fever incidence from large-scale facility-based passive surveillance data.Statistics in medicine · 2021Article
- Antimicrobial Resistance in Typhoidal Salmonella: Surveillance for Enteric Fever in Asia Project, 2016-2019.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- The Surveillance for Enteric Fever in Asia Project (SEAP), Severe Typhoid Fever Surveillance in Africa (SETA), Surveillance of Enteric Fever in India (SEFI), and Strategic Typhoid Alliance Across Africa and Asia (STRATAA) Population-based Enteric Fever Studies: A Review of Methodological Similarities and Differences.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Review
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11 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundIn surveillance for typhoid fever, under-detection of cases occurs when patients with fever do not seek medical care, or seek medical care but do not receive a blood test. Missing data may result in incorrect estimates of disease incidence.
methodsWe used data from an ongoing randomised clinical trial of typhoid conjugate vaccine among children in Nepal to determine if eligible patients attending our fever clinics who did not have blood taken for culture had a lower risk of disease than those who had blood drawn. We assessed clinical and demographic predictors of having blood taken for culture, and predictors of culture-positive results. Missing blood culture data were imputed using multiple imputations.
resultsDuring the first year of surveillance, 2392 fever presentations were recorded and 1615 (68%) of these had blood cultures. Children were more likely to have blood taken for culture if they were older, had fever for longer, a current temperature ≥38 degrees, or if typhoid or a urinary tract infection were suspected. Based on imputation models, those with blood cultures were 1.87 times more likely to have blood culture-positive fever than those with missing data.
conclusionClinical opinion on the cause of the fever may play a large part in the decision to offer blood culture, regardless of study protocol. Crude typhoid incidence estimates should be adjusted for the proportion of cases that go undetected due to missing blood cultures while adjusting for the lower likelihood of culture-positivity in the group with missing data.
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