ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Burden of Culture Confirmed Enteric Fever Cases in Karachi, Pakistan: Surveillance For Enteric Fever in Asia Project (SEAP), 2016-2019.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Typhoid Fever in the Eastern Mediterranean Region: A Systematic Review, 1990-2021.The American journal of tropical medicine and hygiene · 2023Pooled it
- Evaluation of mdh, dld, tcfA, and folE gene markers for detection of enteric fever using real-time PCR.Scientific reports · 2026Article
- Frequency of typhoid-related intestinal perforation with atypical clinical presentation at Tertiary Care Hospital in Pakistan.Pakistan journal of medical sciences · 2025Article
- A contemporary genomic snapshot ofMicrobial genomics · 2025Article
- Trends of Enteric Fever and Emergence of Extensively Drug-Resistant Typhoid in Pakistan: Population-Based Laboratory Data From 2017-2019.Open forum infectious diseases · 2025Article
- WHO preferred product characteristics for bivalent Salmonella Typhi/Paratyphi A vaccine for comprehensive protection against enteric fever- key considerations and research gaps.Gates open research · 2025Review
- Progress on the Global Research Agenda for Antimicrobial Resistance in Human Health in Pakistan: Findings and Implications.Infection and drug resistance · 2025Review
- Ceftriaxone resistant Salmonella enterica serovar Paratyphi A identified in a case of enteric fever: first case report from Pakistan.BMC infectious diseases · 2023Article
- Comparison of Single vs Combination Drug Therapy in Extensively Drug ResistantInfection and drug resistance · 2022Article
- Emerging Trends of Multidrug-Resistant (MDR) and Extensively Drug-Resistant (XDR)Microorganisms · 2021Article
- Effectiveness of typhoid conjugate vaccine against culture-confirmed Salmonella enterica serotype Typhi in an extensively drug-resistant outbreak setting of Hyderabad, Pakistan: a cohort study.The Lancet. Global health · 2021Article
- Introducing Typhoid Conjugate Vaccine in South Asia: Lessons From the Surveillance for Enteric Fever in Asia Project.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Utilization of Blood Culture in South Asia for the Diagnosis and Treatment of Febrile Illness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
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18 authors at 6 institutions in 3 countries.
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Abstract
backgroundThe Surveillance for Enteric Fever in Asia Project (SEAP) is a multicenter, multicountry study conducted in Pakistan, Nepal, and Bangladesh. The objectives of the study were to characterize disease incidence among patients with enteric fever. We report the burden of enteric fever at selected sites of Karachi, Pakistan.
methodsDuring September 2016 to September 2019, prospective surveillance was conducted at inpatient, outpatient, surgical departments, and laboratory networks of Aga Khan University Hospital, Kharadar General Hospital, and surgery units of National Institute of Child Health and Jinnah Postgraduate Medical Centre. Socio-demographic, clinical, and laboratory data were obtained from all suspected or confirmed enteric fever cases.
resultsOverall, 22% (2230/10 094) of patients enrolled were culture-positive for enteric fever. 94% (2093/2230) of isolates were Salmonella Typhi and 6% (137/2230) were S. Paratyphi. 15% of isolates multi-drug resistant (MDR) to first-line antibiotics and 60% were extensively drug-resistant (XDR), resistant to first-line antibiotics, fluoroquinolones and third generation cephalosporin.
conclusionEnteric fever cases have increased during the last 3 years with large proportion of drug resistant S. Typhi cases. However, the burden of paratyphoid is still relatively low. Strengthening the existing surveillance system for enteric fever and antimicrobial resistance at the national level is recommended in Pakistan to inform prevention measures. While typhoid vaccination can significantly decrease the burden of typhoid and may also impact antimicrobial resistance, water, sanitation, and hygiene improvement is highly recommended to prevent the spread of enteric fever.
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