A cross-sectional seroepidemiological survey of typhoid fever in Fiji
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Watson, Connall H.; Baker, Stephen; Lau, Colleen; Rawalai, Kitione; Taufa, Mere; Coriakula, Jerimaia; Vu Thieu Nga, Tran; Van, Tan Trinh; Ngoc, Dung Tran Thi; Hens, Niel; Lowry, John H; de Alwis, Ruklanthi; Cano, Jorge; Jenkins, Kylie; Mulholland, E. Kim; Nilles, Eric J; Kama, Mike; Edmunds, W. John
Description
Fiji, an upper-middle income state in the Pacific Ocean, has experienced an increase in confirmed case notifications of enteric fever caused by Salmonella enterica serovar Typhi (S. Typhi). To characterize the epidemiology of typhoid exposure, we conducted a cross-sectional sero-epidemiological survey measuring IgG against the Vi antigen of S. Typhi to estimate the effect of age, ethnicity, and other variables on seroprevalence. Epidemiologically relevant cut-off titres were established using a...[Show more]
dc.contributor.author | Watson, Connall H. | |
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dc.contributor.author | Baker, Stephen | |
dc.contributor.author | Lau, Colleen | |
dc.contributor.author | Rawalai, Kitione | |
dc.contributor.author | Taufa, Mere | |
dc.contributor.author | Coriakula, Jerimaia | |
dc.contributor.author | Vu Thieu Nga, Tran | |
dc.contributor.author | Van, Tan Trinh | |
dc.contributor.author | Ngoc, Dung Tran Thi | |
dc.contributor.author | Hens, Niel | |
dc.contributor.author | Lowry, John H | |
dc.contributor.author | de Alwis, Ruklanthi | |
dc.contributor.author | Cano, Jorge | |
dc.contributor.author | Jenkins, Kylie | |
dc.contributor.author | Mulholland, E. Kim | |
dc.contributor.author | Nilles, Eric J | |
dc.contributor.author | Kama, Mike | |
dc.contributor.author | Edmunds, W. John | |
dc.date.accessioned | 2021-04-27T23:33:36Z | |
dc.date.available | 2021-04-27T23:33:36Z | |
dc.identifier.issn | 1935-2727 | |
dc.identifier.uri | http://hdl.handle.net/1885/231051 | |
dc.description.abstract | Fiji, an upper-middle income state in the Pacific Ocean, has experienced an increase in confirmed case notifications of enteric fever caused by Salmonella enterica serovar Typhi (S. Typhi). To characterize the epidemiology of typhoid exposure, we conducted a cross-sectional sero-epidemiological survey measuring IgG against the Vi antigen of S. Typhi to estimate the effect of age, ethnicity, and other variables on seroprevalence. Epidemiologically relevant cut-off titres were established using a mixed model analysis of data from recovering culture-confirmed typhoid cases. We enrolled and assayed plasma of 1787 participants for anti-Vi IgG; 1,531 of these were resident in mainland areas that had not been previously vaccinated against S. Typhi (seropositivity 32.3% (95%CI 28.2 to 36.3%)), 256 were resident on Taveuni island, which had been previously vaccinated (seropositivity 71.5% (95%CI 62.1 to 80.9%)). The seroprevalence on the Fijian mainland is one to two orders of magnitude higher than expected from confirmed case surveillance incidence, suggesting substantial subclinical or otherwise unreported typhoid. We found no significant differences in seropositivity prevalences by ethnicity, which is in contrast to disease surveillance data in which the indigenous iTaukei Fijian population are disproportionately affected. Using multivariable logistic regression, seropositivity was associated with increased age (odds ratio 1.3 (95% CI 1.2 to 1.4) per 10 years), the presence of a pit latrine (OR 1.6, 95%CI 1.1 to 2.3) as opposed to a septic tank or piped sewer, and residence in settlements rather than residential housing or villages (OR 1.6, 95% CI 1.0 to 2.7). Increasing seropositivity with age is suggestive of low-level endemic transmission in Fiji. Improved sanitation where pit latrines are used and addressing potential transmission routes in settlements may reduce exposure to S. Typhi. Widespread unreported infection suggests there may be a role for typhoid vaccination in Fiji, in addition to public health management of cases and outbreaks. | |
dc.description.sponsorship | Fieldwork was funded by the World Health Organization Western Pacific Region (www. wpro.who.int) and by the Chadwick Trust(ucl.ac. uk/srs/our-services/academic-services/chadwicktrust). CHW is supported by the UK Medical Research Council (grant MR/J003999/1, mrc.ac. uk). SB and RdA are funded by the Wellcome Trust of Great Britain (wellcome.ac.uk). CLL was supported by a research grant from the Global Change Institute (607562) at The University of Queensland (uq.edu.au) | |
dc.format.mimetype | application/pdf | |
dc.language.iso | en_AU | |
dc.publisher | Public Library of Science | |
dc.rights | © 2017 Watson et al. | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | |
dc.source | PLoS Neglected Tropical Diseases | |
dc.title | A cross-sectional seroepidemiological survey of typhoid fever in Fiji | |
dc.type | Journal article | |
local.description.notes | Imported from ARIES | |
local.identifier.citationvolume | 11 | |
dc.date.issued | 2017 | |
local.identifier.absfor | 111706 - Epidemiology | |
local.identifier.absfor | 111700 - PUBLIC HEALTH AND HEALTH SERVICES | |
local.identifier.ariespublication | u5684624xPUB208 | |
local.publisher.url | http://www.plosNTDS.org/ | |
local.type.status | Published Version | |
local.contributor.affiliation | Watson, Connall H., London School of Hygiene and Tropical Medicine | |
local.contributor.affiliation | Baker, Stephen, The Hospital for Tropical Diseases | |
local.contributor.affiliation | Lau, Colleen, College of Health and Medicine, ANU | |
local.contributor.affiliation | Rawalai, Kitione, Project Heaven | |
local.contributor.affiliation | Taufa, Mere, Ministry of Health and Medical Services | |
local.contributor.affiliation | Coriakula, Jerimaia, Fiji National University | |
local.contributor.affiliation | Vu Thieu Nga, Tran, The Hospital for Tropical Diseases | |
local.contributor.affiliation | Van, Tan Trinh, The Hospital for Tropical Diseases Oxford University Clinical Research Unit | |
local.contributor.affiliation | Ngoc, Dung Tran Thi, The Hospital for Tropical Diseases, Oxford University Clinical Research Unit, | |
local.contributor.affiliation | Hens, Niel, University of Antwerp | |
local.contributor.affiliation | Lowry, John H , School of Geography, Earth Science and Environment, University of the South Pacific, Suva, Fiji | |
local.contributor.affiliation | de Alwis, Ruklanthi, The Hospital for Tropical Diseases, Oxford University Clinical Research Unit | |
local.contributor.affiliation | Cano, Jorge, London School of Hygiene & Tropical Medicine | |
local.contributor.affiliation | Jenkins, Kylie, Fiji Health Sector Support Programme | |
local.contributor.affiliation | Mulholland, E. Kim, London School of Hygiene & Tropical Medicine | |
local.contributor.affiliation | Nilles, Eric J, Division of Pacific Technical Support, World Health Organization, Suva, Fiji | |
local.contributor.affiliation | Kama, Mike, Fiji Centre for Communicable Disease Control | |
local.contributor.affiliation | Edmunds, W. John, Fiji Centre for Communicable Disease Control, Ministry of Health and Medical Services, | |
local.bibliographicCitation.issue | 7 | |
local.bibliographicCitation.startpage | e0005786 | |
local.bibliographicCitation.lastpage | e0005786 | |
local.identifier.doi | 10.1371/journal.pntd.0005786 | |
dc.date.updated | 2020-11-23T10:05:01Z | |
local.identifier.thomsonID | 000408057300080 | |
dcterms.accessRights | Open Access | |
dc.provenance | 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.rights.license | Creative Commons Attribution License | |
Collections | ANU Research Publications |
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