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- W4387208463 abstract "Abstract Background Environmental surveillance (ES) for Salmonella Typhi potentially offers a low-cost tool to identify communities with a high burden of typhoid fever. Methods We developed standardised protocols for typhoid ES, including sampling site selection, validation, characterisation; grab or trap sample collection, concentration; and quantitative PCR targeting Salmonella genes (ttr, staG and tviB) and a marker of human faecal contamination (HF183). ES was implemented over 12-months in a historically high typhoid fever incidence setting (Vellore, India) and a lower incidence setting (Blantyre, Malawi) during 2021-2022. Results S. Typhi prevalence in ES samples was higher in Vellore compared with Blantyre; 39/520 (7.5%, 95% Confidence Interval 4.4-12.4%) vs. 11/533 (2.1%, 1.1-4.0%) in grab and 79/517 (15.3%, 9.8-23.0%) vs. 23/594 (3.9%, 1.9-7.9%) in trap samples. Detection was clustered by ES site and correlated with site catchment population in Vellore but not Blantyre. Incidence of culture-confirmed typhoid in local hospitals was low during the study and zero some months in Vellore despite S. Typhi detection in ES. Conclusions ES describes the prevalence and distribution of S. Typhi even in the absence of typhoid cases and could inform vaccine introduction. Expanded implementation and comparison with clinical and serological surveillance will further establish its public health utility." @default.
- W4387208463 created "2023-09-30" @default.
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- W4387208463 date "2023-09-29" @default.
- W4387208463 modified "2023-10-14" @default.
- W4387208463 title "Environmental surveillance for <i>Salmonella</i> Typhi and its association with typhoid fever incidence in India and Malawi" @default.
- W4387208463 doi "https://doi.org/10.1093/infdis/jiad427" @default.
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