ArticleThe Lancet. Global health2021
Burden of enteric fever at three urban sites in Africa and Asia: a multicentre population-based study.
Article in The Lancet. Global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05475379 (A Randomized Control, Double Blinded, Non-inferiority Trial to Evaluate the Immunogenicity and Safety of Typhoid Vi Conjugate Vaccine 'Typhocon' in Bangladeshi Healthy Population), which is not on this map. Cited by 53 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Control, Double Blinded, Non-inferiority Trial to Evaluate the Immunogenicity and Safety of Typhoid Vi Conjugate Vaccine 'Typhocon' in Bangladeshi Healthy Population
Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Progress on implementing the WHO-GLASS recommendations on priority pathogen-antibiotic sensitivity testing in Africa: AWellcome open research · 2024Pooled it
- Treatment of enteric fever (typhoid and paratyphoid fever) with cephalosporins.The Cochrane database of systematic reviews · 2022Pooled it
- Single and two-dose typhoid conjugate vaccine safety and immunogenicity in HIV-exposed uninfected and HIV-unexposed uninfected Malawian children.Human vaccines & immunotherapeutics · 2024Trial
- Efficacy of typhoid conjugate vaccine: final analysis of a 4-year, phase 3, randomised controlled trial in Malawian children.Lancet (London, England) · 2024Trial
- Typhoid conjugate vaccine effectiveness in Malawi: evaluation of a test-negative design using randomised, controlled clinical trial data.The Lancet. Global health · 2023Trial
- Safety and immunogenicity of a typhoid conjugate vaccine among children aged 9 months to 12 years in Malawi: a nested substudy of a double-blind, randomised controlled trial.The Lancet. Global health · 2022Trial
- From Misinformation to Public Distrust: Urgency of Evidence-Based Transparency, Communication and Community Engagement for Bangladesh's Typhoid Vaccination.Health science reports · 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
- ConfrontingInfection and drug resistance · 2026Review
- Innovative hematological strategies to combat maternal and child mortality in Africa: focus on anemia and sickle cell disease.Annals of medicine and surgery (2012) · 2026Review
- Impact of the COVID-19 pandemic and typhoid conjugate vaccine introduction on typhoid fever in Nepal.PLoS neglected tropical diseases · 2026Article
- Leveraging paired serology to estimate the incidence of typhoidal Salmonella infection in the STRATAA study.PLoS neglected tropical diseases · 2025Article
- Shifting Enteric Fever Epidemiology in Children in Nepal: Is the Burden ofJNMA; journal of the Nepal Medical Association · 2025Observational
- Comparative Epidemiology of Salmonella enterica Serovers Paratyphi A and Typhi Causing Enteric Fever, Bangladesh, 2018-2020.Emerging infectious diseases · 2025Article
- Phage-mediated horizontal transfer ofiMeta · 2025Article
- Interplay between the gut microbiome and typhoid fever: insights from endemic countries and a controlled human infection model.Microbiome · 2025Article
- Article
- Article
- Immunogenicity and reactogenicity of a booster dose of a typhoid conjugate vaccine (TCV) in Malawian pre-school children.EClinicalMedicine · 2025Article
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24 authors.
Funding
Abstract
backgroundEnteric fever is a serious public health concern in many low-income and middle-income countries. Numerous data gaps exist concerning the epidemiology of Salmonella enterica serotype Typhi (S Typhi) and Salmonella enterica serotype Paratyphi (S Paratyphi), which are the causative agents of enteric fever. We aimed to determine the burden of enteric fever in three urban sites in Africa and Asia.
methodsIn this multicentre population-based study, we did a demographic census at three urban sites in Africa (Blantyre, Malawi) and Asia (Kathmandu, Nepal and Dhaka, Bangladesh) between June 1, 2016, and Sept 25, 2018. Households were selected randomly from the demographic census. Participants from within the geographical census area presenting to study health-care facilities were approached for recruitment if they had a history of fever for 72 h or more (later changed to >48 h) or temperature of 38·0°C or higher. Facility-based passive surveillance was done between Nov 11, 2016, and Dec 31, 2018, with blood-culture collection for febrile illness. We also did a community-based serological survey to obtain data on Vi-antibody defined infections. We calculated crude incidence for blood-culture-confirmed S Typhi and S Paratyphi infection, and calculated adjusted incidence and seroincidence of S Typhi blood-culture-confirmed infection.
findings423 618 individuals were included in the demographic census, contributing 626 219 person-years of observation for febrile illness surveillance. 624 S Typhi and 108 S Paratyphi A isolates were collected from the blood of 12 082 febrile patients. Multidrug resistance was observed in 44% S Typhi isolates and fluoroquinolone resistance in 61% of S Typhi isolates. In Blantyre, the overall crude incidence of blood-culture confirmed S Typhi was 58 cases per 100 000 person-years of observation (95% CI 48-70); the adjusted incidence was 444 cases per 100 000 person-years of observation (95% credible interval [CrI] 347-717). The corresponding rates were 74 (95% CI 62-87) and 1062 (95% CrI 683-1839) in Kathmandu, and 161 (95% CI 145-179) and 1135 (95% CrI 898-1480) in Dhaka. S Paratyphi was not found in Blantyre; overall crude incidence of blood-culture-confirmed S Paratyphi A infection was 6 cases per 100 000 person-years of observation (95% CI 3-11) in Kathmandu and 42 (95% CI 34-52) in Dhaka. Seroconversion rates for S Typhi infection per 100 000 person-years estimated from anti-Vi seroconversion episodes in serological surveillance were 2505 episodes (95% CI 1605-3727) in Blantyre, 7631 (95% CI 5913-9691) in Kathmandu, and 3256 (95% CI 2432-4270) in Dhaka.
interpretationHigh disease incidence and rates of antimicrobial resistance were observed across three different transmission settings and thus necessitate multiple intervention strategies to achieve global control of these pathogens.
fundingWellcome Trust and the Bill & Melinda Gates Foundation.
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