Burden of Typhoid and Paratyphoid Fever in India

This Original Article presents data from the NSSEFI study conducted from 2017 to 2020 across 10 Indian sites four tier 1 cohorts and six tier 2 hospital-based surveillance locations to quantify the incidence of typhoid and paratyphoid fever. Active surveillance in tier 1 enrolled 24,062 children aged 6 months to 14 years with 46,959 child-years of follow-up, yielding 299 culture-confirmed typhoid cases (urban incidence: 576–1173/100,000 child-years; rural Pune: 35). An additional 33 children had paratyphoid fever (adjusted incidence: 68/100,000 child-years). Tier 2 estimated incidence from hospitalized patients using adjusted models based on health care utilization and blood culture sensitivity. Urban typhoid incidence among children peaked at 1622/100,000 person-years in Chandigarh; rural estimates varied widely. Antibiotic usage was high, with emerging resistance to azithromycin and ciprofloxacin. 

This Original Article presents data from the NSSEFI study conducted from 2017 to 2020 across 10 Indian sites four tier 1 cohorts and six tier 2 hospital-based surveillance locations to quantify the incidence of typhoid and paratyphoid fever. Active surveillance in tier 1 enrolled 24,062 children aged 6 months to 14 years with 46,959 child-years of follow-up, yielding 299 culture-confirmed typhoid cases (urban incidence: 576–1173/100,000 child-years; rural Pune: 35). An additional 33 children had paratyphoid fever (adjusted incidence: 68/100,000 child-years). Tier 2 estimated incidence from hospitalized patients using adjusted models based on health care utilization and blood culture sensitivity. Urban typhoid incidence among children peaked at 1622/100,000 person-years in Chandigarh; rural estimates varied widely. Antibiotic usage was high, with emerging resistance to azithromycin and ciprofloxacin.