Facility-based disease surveillance and Bayesian hierarchical modeling to estimate endemic typhoid fever incidence, Kilimanjaro Region, Tanzania, 2007-2018.

Autor: Cutting ER; Duke University School of Medicine, Division of Infectious Diseases and International Health, Durham, North Carolina, United States of America., Simmons RA; Duke Global Health Institute, Durham, North Carolina, United States of America.; Duke University School of Medicine, Department of Biostatistics & Bioinformatics, Durham, North Carolina, United States of America., Madut DB; Duke University School of Medicine, Division of Infectious Diseases and International Health, Durham, North Carolina, United States of America., Maze MJ; University of Otago, Christchurch, New Zealand.; Centre for International Health, University of Otago, Dunedin, New Zealand., Kalengo NH; Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Carugati M; Duke University School of Medicine, Division of Infectious Diseases and International Health, Durham, North Carolina, United States of America., Mbwasi RM; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Kilonzo KG; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Lyamuya F; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Marandu A; Mawenzi Regional Referral Hospital, Moshi, Tanzania., Mosha C; Mawenzi Regional Referral Hospital, Moshi, Tanzania., Saganda W; Mawenzi Regional Referral Hospital, Moshi, Tanzania., Lwezaula BF; Mawenzi Regional Referral Hospital, Moshi, Tanzania., Hertz JT; Duke Global Health Institute, Durham, North Carolina, United States of America., Morrissey AB; Duke University School of Medicine, Division of Infectious Diseases and International Health, Durham, North Carolina, United States of America., Turner EL; Duke Global Health Institute, Durham, North Carolina, United States of America.; Duke University School of Medicine, Department of Biostatistics & Bioinformatics, Durham, North Carolina, United States of America., Mmbaga BT; Duke Global Health Institute, Durham, North Carolina, United States of America.; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Kilimanjaro Clinical Research Institute, Moshi, Tanzania., Kinabo GD; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Maro VP; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Crump JA; Duke University School of Medicine, Division of Infectious Diseases and International Health, Durham, North Carolina, United States of America.; Duke Global Health Institute, Durham, North Carolina, United States of America.; Centre for International Health, University of Otago, Dunedin, New Zealand.; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Rubach MP; Duke University School of Medicine, Division of Infectious Diseases and International Health, Durham, North Carolina, United States of America.; Duke Global Health Institute, Durham, North Carolina, United States of America.; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2022 Jul 05; Vol. 16 (7), pp. e0010516. Date of Electronic Publication: 2022 Jul 05 (Print Publication: 2022).
DOI: 10.1371/journal.pntd.0010516
Abstrakt: Growing evidence suggests considerable variation in endemic typhoid fever incidence at some locations over time, yet few settings have multi-year incidence estimates to inform typhoid control measures. We sought to describe a decade of typhoid fever incidence in the Kilimanjaro Region of Tanzania. Cases of blood culture confirmed typhoid were identified among febrile patients at two sentinel hospitals during three study periods: 2007-08, 2011-14, and 2016-18. To account for under-ascertainment at sentinel facilities, we derived adjustment multipliers from healthcare utilization surveys done in the hospital catchment area. Incidence estimates and credible intervals (CrI) were derived using a Bayesian hierarchical incidence model that incorporated uncertainty of our observed typhoid fever prevalence, of healthcare seeking adjustment multipliers, and of blood culture diagnostic sensitivity. Among 3,556 total participants, 50 typhoid fever cases were identified. Of typhoid cases, 26 (52%) were male and the median (range) age was 22 (<1-60) years; 4 (8%) were aged <5 years and 10 (20%) were aged 5 to 14 years. Annual typhoid fever incidence was estimated as 61.5 (95% CrI 14.9-181.9), 6.5 (95% CrI 1.4-20.4), and 4.0 (95% CrI 0.6-13.9) per 100,000 persons in 2007-08, 2011-14, and 2016-18, respectively. There were no deaths among typhoid cases. We estimated moderate typhoid incidence (≥10 per 100 000) in 2007-08 and low (<10 per 100 000) incidence during later surveillance periods, but with overlapping credible intervals across study periods. Although consistent with falling typhoid incidence, we interpret this as showing substantial variation over the study periods. Given potential variation, multi-year surveillance may be warranted in locations making decisions about typhoid conjugate vaccine introduction and other control measures.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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