Assessing the Feasibility of Typhoid Elimination
| Autor: | John A. Crump, Stephen P. Luby, Phionah Atuhebwe, Jeffrey D. Stanaway |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
Sanitation Supplement Articles World Health Organization Typhoid Conjugate Vaccine and the Future of Enteric Fever Control and Prevention Salmonella typhi complex mixtures Typhoid fever World health elimination Effective interventions vaccine Humans Medicine Typhoid Fever Disease Eradication business.industry Task force Typhoid-Paratyphoid Vaccines bacterial infections and mycoses medicine.disease Food safety AcademicSubjects/MED00290 Infectious Diseases Risk analysis (engineering) Feasibility Studies business control typhoid |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/ciaa585 |
| Popis: | In 1993, the International Task Force on Disease Eradication classified the political will for typhoid eradication as “none.” Here we revisit the Task Force’s assessment in light of developments in typhoid vaccines and increasing antimicrobial resistance in Salmonella Typhi that have served to increase interest in typhoid elimination. Considering the requisite biological and technical factors for elimination, effective interventions exist for typhoid, and humans are the organism’s only known reservoir. Improvements in water supply, sanitation, hygiene, and food safety are critical for robust long-term typhoid control, and the recent Strategic Advisory Group of Experts on Immunization recommendation and World Health Organization prequalification should make typhoid conjugate vaccine more accessible and affordable in low-income countries, which will allow the vaccine to offer a critical bridge to quickly reduce burden. While these developments are encouraging, all current typhoid diagnostics are inadequate, having either poor performance characteristics, limited scalability, or both. No clear solution exists, and this should be viewed as a critical challenge to any elimination effort. Moreover, asymptomatic carriers and limited data and surveillance remain major challenges, and countries considering elimination campaigns will need to develop strategies to identify high-risk populations and to monitor progress over time. Finally, policymakers must be realistic in planning, learn from the planning failures of previous elimination and eradication efforts, and expect unforeseeable shocks and setbacks. In the end, if we assume neither unanticipated breakthroughs in typhoid control nor any chaotic shocks, history suggests that we should expect typhoid elimination to take decades. |
| Databáze: | OpenAIRE |
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