Phylogeography and incidence of multidrug resistant typhoid fever in Sub-Saharan Africa

The typhoid fever surveillance program (TSAP) estimated the typhoid fever burden across 10 countries in Sub-Saharan Africa, including the Bandim Health Project study area in Guinea-Bissau (Marks F et al, Lancet Global Health, 2017). While only a moderate typhoid fever burden was identified in Guinea-Bissau, high rates were found in Burkina Faso, Ghana and Kenya. In the present paper, published in Nature Communications, the phylogeography and incidence of multidrug resistant (MDR) typhoid fever were examined using TSAP samples, while adding samples from other studies conducted outside the TSAP framework as well.

Overall, there was a broad genetic diversity in salmonella typhi, but 90% (225/249) of the organisms belonged to only three genotypes. Distinct genotypes were observed in West and East Africa, respectively, with typhoid fever in East Africa likely related to the spread from South Asia. There was a huge variation in MDR typhoid fever rates, but countries with high typhoid burden also had the highest incidences of MDR s. typhi. The findings have considerable implications for future typhoid fever prevention and control strategies, including targeted vaccination programs against the disease.

You can read the full article here: Phylogeography and incidence of MDR typhoid fever in Sub-Saharan Africa Nature Communications 2018