Population-based incidence of typhoid fever in an urban informal settlement and a rural area in Kenya: implications for typhoid vaccine use in Africa
| Autor: | Beatrice Olack, John B. Ochieng, Newton Wamola, Heather Burke, Collins Tabu, Henry Njuguna, Leonard Cosmas, Joseph Oundo, Allan Audi, George Awiti, Godfrey Bigogo, Daniel R. Feikin, John Williamson, Eric D. Mintz, Robert F. Breiman |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
Rural Population Bacterial Diseases Veterinary medicine Urban Population Epidemiology media_common.quotation_subject Population lcsh:Medicine Global Health Urban area Salmonella typhi Typhoid fever Hygiene Environmental health Humans Medicine Typhoid Fever lcsh:Science Child education Biology media_common geography education.field_of_study Multidisciplinary geography.geographical_feature_category Population Biology business.industry Incidence Incidence (epidemiology) lcsh:R Typhoid-Paratyphoid Vaccines medicine.disease Infectious Diseases Child Preschool Africa Typhoid vaccine lcsh:Q Female Rural area business Research Article |
| Zdroj: | PLoS ONE PLoS ONE, Vol 7, Iss 1, p e29119 (2012) |
| ISSN: | 1932-6203 |
| Popis: | Background High rates of typhoid fever in children in urban settings in Asia have led to focus on childhood immunization in Asian cities, but not in Africa, where data, mostly from rural areas, have shown low disease incidence. We set out to compare incidence of typhoid fever in a densely populated urban slum and a rural community in Kenya, hypothesizing higher rates in the urban area, given crowding and suboptimal access to safe water, sanitation and hygiene. Methods During 2007-9, we conducted population-based surveillance in Kibera, an urban informal settlement in Nairobi, and in Lwak, a rural area in western Kenya. Participants had free access to study clinics; field workers visited their homes biweekly to collect information about acute illnesses. In clinic, blood cultures were processed from patients with fever or pneumonia. Crude and adjusted incidence rates were calculated. Results In the urban site, the overall crude incidence of Salmonella enterica serovar Typhi (S. Typhi) bacteremia was 247 cases per 100,000 person-years of observation (pyo) with highest rates in children 5–9 years old (596 per 100,000 pyo) and 2–4 years old (521 per 100,000 pyo). Crude overall incidence in Lwak was 29 cases per 100,000 pyo with low rates in children 2–4 and 5–9 years old (28 and 18 cases per 100,000 pyo, respectively). Adjusted incidence rates were highest in 2–4 year old urban children (2,243 per 100,000 pyo) which were >15-fold higher than rates in the rural site for the same age group. Nearly 75% of S. Typhi isolates were multi-drug resistant. Conclusions This systematic urban slum and rural comparison showed dramatically higher typhoid incidence among urban children |
| Databáze: | OpenAIRE |
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