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The burden and characteristics of enteric fever at a healthcare facility in a densely populated area of Kathmandu

Karkey, Abhilasha; Arjyal, Amit; Anders, Katherine L.; Boni, Maciej F.; Dongol, Sabina; Koirala, Samir; My, Phan Vu Tra; Nga, Tran Vu Thieu; Clements, Archie C. A.; Holt, Kathryn E.; Duy, Pham Thanh; Day, Jeremy N.; Campbell, James I.; Dougan, Gordon; Dolecek, Christiane; Farrar, Jeremy; Basnyat, Buddha; Baker, Stephen

Description

Enteric fever, caused by Salmonella enterica serovars Typhi and Paratyphi A (S. Typhi and S. Paratyphi A) remains a major public health problem in many settings. The disease is limited to locations with poor sanitation which facilitates the transmission of the infecting organisms. Efficacious and inexpensive vaccines are available for S. Typhi, yet are not commonly deployed to control the disease. Lack of vaccination is due partly to uncertainty of the disease burden arising from a paucity of...[Show more]

dc.contributor.authorKarkey, Abhilasha
dc.contributor.authorArjyal, Amit
dc.contributor.authorAnders, Katherine L.
dc.contributor.authorBoni, Maciej F.
dc.contributor.authorDongol, Sabina
dc.contributor.authorKoirala, Samir
dc.contributor.authorMy, Phan Vu Tra
dc.contributor.authorNga, Tran Vu Thieu
dc.contributor.authorClements, Archie C. A.
dc.contributor.authorHolt, Kathryn E.
dc.contributor.authorDuy, Pham Thanh
dc.contributor.authorDay, Jeremy N.
dc.contributor.authorCampbell, James I.
dc.contributor.authorDougan, Gordon
dc.contributor.authorDolecek, Christiane
dc.contributor.authorFarrar, Jeremy
dc.contributor.authorBasnyat, Buddha
dc.contributor.authorBaker, Stephen
dc.date.accessioned2015-11-04T01:31:42Z
dc.date.available2015-11-04T01:31:42Z
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/1885/16316
dc.description.abstractEnteric fever, caused by Salmonella enterica serovars Typhi and Paratyphi A (S. Typhi and S. Paratyphi A) remains a major public health problem in many settings. The disease is limited to locations with poor sanitation which facilitates the transmission of the infecting organisms. Efficacious and inexpensive vaccines are available for S. Typhi, yet are not commonly deployed to control the disease. Lack of vaccination is due partly to uncertainty of the disease burden arising from a paucity of epidemiological information in key locations. We have collected and analyzed data from 3,898 cases of blood culture-confirmed enteric fever from Patan Hospital in Lalitpur Sub-Metropolitan City (LSMC), between June 2005 and May 2009. Demographic data was available for a subset of these patients (n = 527) that were resident in LSMC and who were enrolled in trials. We show a considerable burden of enteric fever caused by S. Typhi (2,672; 68.5%) and S. Paratyphi A (1,226; 31.5%) at this Hospital over a four year period, which correlate with seasonal fluctuations in rainfall. We found that local population density was not related to incidence and we identified a focus of infections in the east of LSMC. With data from patients resident in LSMC we found that the median age of those with S. Typhi (16 years) was significantly less than S. Paratyphi A (20 years) and that males aged 15 to 25 were disproportionately infected. Our findings provide a snapshot into the epidemiological patterns of enteric fever in Kathmandu. The uneven distribution of enteric fever patients within the population suggests local variation in risk factors, such as contaminated drinking water. These findings are important for initiating a vaccination scheme and improvements in sanitation. We suggest any such intervention should be implemented throughout the LSMC area.
dc.description.sponsorshipThis work was supported by The Wellcome Trust, Euston Road, London, United Kingdom. MFB is supported by the Medical Research Council (grant G0600718). SB is supported by an OAK foundation fellowship through Oxford University.
dc.format8 pages
dc.publisherPublic Library of Science
dc.rights©2010 Karkey et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.sourcePLoS ONE
dc.subjectadolescent
dc.subjectadult
dc.subjectage factors
dc.subjectchild
dc.subjectchild, preschool
dc.subjectcross infection
dc.subjectfemale
dc.subjectgeography
dc.subjecthealth facilities
dc.subjecthumans
dc.subjectincidence
dc.subjectmale
dc.subjectmiddle aged
dc.subjectnepal
dc.subjectparatyphoid fever
dc.subjectpopulation density
dc.subjectprevalence
dc.subjectsalmonella paratyphi a
dc.subjectsalmonella typhi
dc.subjectseasons
dc.subjectspecies specificity
dc.subjecttyphoid fever
dc.subjectyoung adult
dc.titleThe burden and characteristics of enteric fever at a healthcare facility in a densely populated area of Kathmandu
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume5
dcterms.dateAccepted2010-10-15
dc.date.issued2010-11-15
local.identifier.absfor111706
local.identifier.ariespublicationU3488905xPUB4129
local.publisher.urlhttps://www.plos.org/
local.type.statusPublished Version
local.contributor.affiliationKarkey, Abhilasha, Patan Academy of Health Sciences, Nepal
local.contributor.affiliationArjyal, Amit, Patan Academy of Health Sciences, Nepal
local.contributor.affiliationAnders, Katherine L, The Hospital for Tropical Diseases, Vietnam
local.contributor.affiliationBoni, Maciej F, The Hospital for Tropical Diseases, Vietnam
local.contributor.affiliationDongol, Sabina, Patan Academy of Health Sciences, Nepal
local.contributor.affiliationKoirala, Samir, Patan Academy of Health Sciences, Nepal
local.contributor.affiliationVu Tra My, Phan, The Hospital for Tropical Diseases, Vietnam
local.contributor.affiliationVu Thieu Nga, Tran, The Hospital for Tropical Diseases, Vietnam
local.contributor.affiliationClements, Archie, College of Medicine, Biology and Environment, CMBE Research School of Population Health, Natl Centre for Epidemiology & Population Health, The Australian National University
local.contributor.affiliationHolt, Kathryn E, The University of Melbourne, Australia
local.contributor.affiliationThanh Duy, Pham, The Hospital for Tropical Diseases, Vietnam
local.contributor.affiliationDay, Jeremy N, The Hospital for Tropical Diseases, Vietnam
local.contributor.affiliationFarrar, Jeremy, Oxford University Clinical Research Unit, Vietnam
local.identifier.essn1932-6203
local.bibliographicCitation.issue11
local.bibliographicCitation.startpagee13988
local.bibliographicCitation.lastpage8
local.identifier.doi10.1371/journal.pone.0013988
local.identifier.absseo920109
dc.date.updated2015-12-11T08:43:54Z
local.identifier.scopusID2-s2.0-78649739204
CollectionsANU Research Publications

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