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ABSTRACT: Background
Typhoid is known to be heterogenous in time and space, with documented spatiotemporal clustering and hotspots associated with environmental factors. This analysis evaluated spatial clustering of typhoid and modeled incidence rates of typhoid from active surveillance at 4 sites with child cohorts in India.Methods
Among approximately 24 000 children aged 0.5-15 years followed for 2 years, typhoid was confirmed by blood culture in all children with fever >3 days. Local hotspots for incident typhoid cases were assessed using SaTScan spatial cluster detection. Incidence of typhoid was modeled with sociodemographic and water, sanitation, and hygiene-related factors in smaller grids using nonspatial and spatial regression analyses.Results
Hotspot households for typhoid were identified at Vellore and Kolkata. There were 4 significant SaTScan clusters (P < .05) for typhoid in Vellore. Mean incidence of typhoid was 0.004 per child-year with the highest incidence (0.526 per child-year) in Kolkata. Unsafe water and poor sanitation were positively associated with typhoid in Kolkata and Delhi, whereas drinking untreated water was significantly associated in Vellore (P = .0342) and Delhi (P = .0188).Conclusions
Despite decades of efforts to improve water and sanitation by the Indian government, environmental factors continue to influence the incidence of typhoid. Hence, administration of the conjugate vaccine may be essential even as efforts to improve water and sanitation continue.
SUBMITTER: Mohan VR
PROVIDER: S-EPMC8892548 | biostudies-literature | 2021 Nov
REPOSITORIES: biostudies-literature
Mohan Venkata Raghava VR Srinivasan Manikandan M Sinha Bireshwar B Shrivastava Ankita A Kanungo Suman S Natarajan Sindhu Kulandaipalayam K Ramanujam Karthikeyan K Ganesan Santhosh Kumar SK Karthikeyan Arun S AS Kumar Jaganathan Senthil S Gunasekaran Annai A Arya Alok A Bavdekar Ashish A Rongsen-Chandola Temsunaro T Dutta Shanta S John Jacob J Kang Gagandeep G
The Journal of infectious diseases 20211101 Supple 5
<h4>Background</h4>Typhoid is known to be heterogenous in time and space, with documented spatiotemporal clustering and hotspots associated with environmental factors. This analysis evaluated spatial clustering of typhoid and modeled incidence rates of typhoid from active surveillance at 4 sites with child cohorts in India.<h4>Methods</h4>Among approximately 24 000 children aged 0.5-15 years followed for 2 years, typhoid was confirmed by blood culture in all children with fever >3 days. Local ho ...[more]