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Peer reviewedOpen accessParatyphoid feverTyphoid feverTyphoid and Paratyphoid fever

The Burden of Typhoid and Paratyphoid in India: Systematic Review and Meta-analysis

PLOS Neglected Tropical Diseases·

Jacob John, Carola J. C. Van Aart, Nicholas C. Grassly

DOI
10.1371/journal.pntd.0004616
PMID
27082958
PMCID
PMC4833325
OpenAlex
W2335972457
Study type
Systematic review
Publisher
Public Library of Science (PLoS)
Article type
journal-article
Integrity
current

Why this research matters now

The findings indicate that typhoid remains a significant public health challenge in India despite apparent declines in prevalence, particularly among young children, and suggest that newly-licensed conjugate vaccines for infant immunization could address this burden, especially amid growing antimicrobial resistance.

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Structured evidence summary

Research question

This systematic review and meta-analysis aimed to characterize the burden of typhoid and paratyphoid fever in India and identify affected age groups and geographic areas to inform decisions about public vaccination programs.

Study design

A systematic review with mixed-effects meta-regression was conducted, searching Medline and Web of Science for studies reporting culture- or serology-confirmed incidence or prevalence of typhoid and paratyphoid in India published between 1950 and 2015.

Population and setting

The review included studies conducted in India spanning 1950 to 2015, with findings indicating that young children bear a disproportionate burden of typhoid infection.

Main findings

From 791 identified records, 37 typhoid and 18 paratyphoid studies were included. The pooled prevalence of confirmed typhoid among febrile individuals was 9.7% (95% CI: 5.7-16.0%) and paratyphoid was 0.9% (95% CI: 0.5-1.7%), with significant heterogeneity observed across studies.

Public-health relevance

The findings indicate that typhoid remains a significant public health challenge in India despite apparent declines in prevalence, particularly among young children, and suggest that newly-licensed conjugate vaccines for infant immunization could address this burden, especially amid growing antimicrobial resistance.

Important limitations

Significant heterogeneity among included studies was noted. This summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation.

GIDS interpretation

This article provides epidemiological burden estimates for typhoid and paratyphoid in India relevant to vaccine policy considerations. The systematic review synthesizes evidence from historical and contemporary studies, supporting contextualization of current surveillance data within documented trends.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 12 auditable classifier relationships to diseases, places, topics, and study design.

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