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Incidence of Typhoid and Paratyphoid Fevers Among Adolescents and Adults in Yangon, Myanmar.
Clin Infect Dis. 2019 03 07; 68(Suppl 2):S124-S129.CI

Abstract

BACKGROUND

Accurate estimates of typhoid disease burden are needed to guide policy decisions, including on vaccine use. Data on the incidence of enteric fever in Myanmar are scarce. We estimated typhoid and paratyphoid fever incidence among adolescents and adults in Yangon, Myanmar, by combining sentinel hospital surveillance with a healthcare utilization survey.

METHODS

We conducted a population-based household health care utilization survey in the Yangon Region 12 March through 5 April 2018. Multipliers derived from this survey were then applied to hospital-based surveillance of Salmonella Typhi and Paratyphi A bloodstream infections from 5 October 2015 through 4 October 2016 at Yangon General Hospital (YGH) to estimate the incidence of typhoid and paratyphoid fevers among person ≥12 years of age.

RESULTS

A total of 336 households representing 1598 persons were enrolled in the health care utilization survey, and multipliers were derived based on responses to questions about healthcare seeking in the event of febrile illness. Of 671 Yangon residents enrolled over a 1-year period at YGH, we identified 33 (4.9%) with Salmonella Typhi and 9 (1.3%) with Salmonella Paratyphi A bloodstream infection. After applying multipliers, we estimated that the annual incidence of typhoid was 391 per 100 000 persons and paratyphoid was 107 per 100 000 persons.

CONCLUSIONS

Enteric fever incidence is high in Yangon, Myanmar, warranting increased attention on prevention and control, including consideration of typhoid conjugate vaccine use as well as nonvaccine control measures. Research on incidence among infants and children, as well as sources and modes of transmission is needed.

Authors+Show Affiliations

Department of Microbiology, University of Medicine 1, Yangon, Myanmar. Centre for International Health, University of Otago, Dunedin, New Zealand.Department of Microbiology, University of Medicine 1, Yangon, Myanmar. Centre for International Health, University of Otago, Dunedin, New Zealand.Department of Microbiology, University of Medicine 1, Yangon, Myanmar.Southern Community Laboratories, Dunedin Hospital. Department of Immunology and Microbiology, University of Otago, Dunedin.Department of Pathology, University of Otago, Christchurch, New Zealand.Department of Preventive and Social Medicine.Department of Medicine, University of Medicine 1, Yangon, Myanmar.Department of Medicine, University of Otago, Christchurch, New Zealand.Department of Preventive and Social Medicine.Centre for International Health, University of Otago, Dunedin, New Zealand.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30845332

Citation

Oo, Win Thandar, et al. "Incidence of Typhoid and Paratyphoid Fevers Among Adolescents and Adults in Yangon, Myanmar." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 68, no. Suppl 2, 2019, pp. S124-S129.
Oo WT, Myat TO, Htike WW, et al. Incidence of Typhoid and Paratyphoid Fevers Among Adolescents and Adults in Yangon, Myanmar. Clin Infect Dis. 2019;68(Suppl 2):S124-S129.
Oo, W. T., Myat, T. O., Htike, W. W., Ussher, J. E., Murdoch, D. R., Lwin, K. T., Oo, M. Z., Maze, M. J., Win, H. H., & Crump, J. A. (2019). Incidence of Typhoid and Paratyphoid Fevers Among Adolescents and Adults in Yangon, Myanmar. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 68(Suppl 2), S124-S129. https://doi.org/10.1093/cid/ciy1109
Oo WT, et al. Incidence of Typhoid and Paratyphoid Fevers Among Adolescents and Adults in Yangon, Myanmar. Clin Infect Dis. 2019 03 7;68(Suppl 2):S124-S129. PubMed PMID: 30845332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence of Typhoid and Paratyphoid Fevers Among Adolescents and Adults in Yangon, Myanmar. AU - Oo,Win Thandar, AU - Myat,Tin Ohn, AU - Htike,Wah Win, AU - Ussher,James E, AU - Murdoch,David R, AU - Lwin,Kay Thi, AU - Oo,Min Zaw, AU - Maze,Michael J, AU - Win,Hla Hla, AU - Crump,John A, PY - 2019/3/8/entrez PY - 2019/3/8/pubmed PY - 2020/5/29/medline KW - Myanmar KW - incidence studies KW - paratyphoid fever KW - typhoid fever KW - typhoid vaccine SP - S124 EP - S129 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 68 IS - Suppl 2 N2 - BACKGROUND: Accurate estimates of typhoid disease burden are needed to guide policy decisions, including on vaccine use. Data on the incidence of enteric fever in Myanmar are scarce. We estimated typhoid and paratyphoid fever incidence among adolescents and adults in Yangon, Myanmar, by combining sentinel hospital surveillance with a healthcare utilization survey. METHODS: We conducted a population-based household health care utilization survey in the Yangon Region 12 March through 5 April 2018. Multipliers derived from this survey were then applied to hospital-based surveillance of Salmonella Typhi and Paratyphi A bloodstream infections from 5 October 2015 through 4 October 2016 at Yangon General Hospital (YGH) to estimate the incidence of typhoid and paratyphoid fevers among person ≥12 years of age. RESULTS: A total of 336 households representing 1598 persons were enrolled in the health care utilization survey, and multipliers were derived based on responses to questions about healthcare seeking in the event of febrile illness. Of 671 Yangon residents enrolled over a 1-year period at YGH, we identified 33 (4.9%) with Salmonella Typhi and 9 (1.3%) with Salmonella Paratyphi A bloodstream infection. After applying multipliers, we estimated that the annual incidence of typhoid was 391 per 100 000 persons and paratyphoid was 107 per 100 000 persons. CONCLUSIONS: Enteric fever incidence is high in Yangon, Myanmar, warranting increased attention on prevention and control, including consideration of typhoid conjugate vaccine use as well as nonvaccine control measures. Research on incidence among infants and children, as well as sources and modes of transmission is needed. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/30845332/Incidence_of_Typhoid_and_Paratyphoid_Fevers_Among_Adolescents_and_Adults_in_Yangon_Myanmar_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciy1109 DB - PRIME DP - Unbound Medicine ER -