The Global Burden of Typhoid Fever

925 words | 4 page(s)

This paper examines global trends in the burden of typhoid fever. The risk factors for typhoid fever are identified as oral transmission as well ingestion of contaminated food and water. Typhoid fever is endemic in poor countries where there are poor sanitation levels and poor education. The infection is also common among children and young adults. An analysis of trends in global burden is enabled by availability of national surveillance data, as well as population studies on the incidence of typhoid fever. Current estimates are that typhoid fever causes 216 510 deaths and 21,650 974 illnesses.

Typhoid fever is an infection caused by a bacterium known as Salmonella typhi (Burke, 2015; Vyas, 2013). The condition is also known as enteric fever and can be fatal (Burke, 2015; Vyas, 2013). Common symptoms of the disease include diarrhea, rashes, fever, constipation, malaise, and abdominal pain. If left untreated, it can lead to delirium, intestinal hemorrhage, and death. The bacterium thrives in conditions such as social chaos, poor sanitation, and crowding (Burke, 2015; Vyas, 2013). Typhoid fever is thus, more common in developing countries. As of 1984, the global burden of typhoid fever was estimated at 600 000 deaths and 16 million illnesses annually. However, that study had limitations that included the fact that age related factors were not considered and China was not included in the study. The method adopted for the study was also not discussed such that they study could not be replicated (Crump, Luby & Mintz, 2004). This research paper looks at the global burden of typhoid fever based on the 2004 study by Crump and colleagues. The paper reviews the measures taken to analyze the spread of the infection as well as how race, socioeconomic status, and education affect its global spread.

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Salmonella typhi has no nonhuman vectors; its mode of transmission includes oral transmission through food or beverages that are handled by carriers, hand-to-mouth transmission where hand hygiene is neglected as well as oral transmission through sewage-contaminated water or fish (Burke, 2015). Although Typhoid fever occurs all over the world, it primary occurs in countries that are poor as such nations have poor sanitary conditions. Typhoid fever is thus, endemic in Africa, Asia, Latin America, and the Caribbean.

When ingested through food or contaminated drink, the bacteria enters the body, it travels into the blood through the intestines. From there, the bacteria enter the gall bladder, spleen, lymph node, liver as well as other parts of the body (Vyas, 2013). Persons who become carriers of the bacteria release the bacteria in stools for years, thus, spreading the disease (Vyas, 2013). If treated promptly, typhoid fever is a short-term febrile illness that involves a short hospital stay. Effective treatment reduces the risk for mortality to 0.2%. Untreated cases can be life-threatening as well as damage the central nervous system (Burke, 2015).

Crump, Luby & Mintz (2004) stated that increased availability of data through disease surveillance, vaccine studies and population-based incidence studies for typhoid fever create a standard framework for assessing the global burden of typhoid fever. The researchers carried out a revised estimation for typhoid fever that involves analysis of data from 1966 to 2001 from studies on typhoid fever that used blood culture confirmation from diagnosed cases as well as captured all healthcare levels. The methodology also included the categorization of global population data by age (5-year strata) and region (21 regions). Extrapolation was done between age groups; age-distribution curve was developed for the United Sates and compared to other national survey data from Asia, Europe, and Australia. Extrapolation was done between countries where data was not available for some countries. This process was based on the United Nation’s socio-economic parameters as well as geographical nearness. The findings of the study were that typhoid fever caused 216 510 deaths and 21,650 974 illnesses while paratyphoid fever caused 5 412 744 illnesses.

The findings by Crump, Luby & Mintz (2004) reveal that across 16 years since the 1984 survey, decreased mortality was recorded (383 490 less) while the morbidity rates increased by approximately 5 million. The researchers said that the 20% increase in global population may account for the increased global burden for typhoid fever in the period studied. Current estimates are that Typhoid fever infects about 21.6 million people and is responsible for 200 000 annual deaths (an incidence of 3.6 persons per 1,000 population) (Burke 2015). Less than 400 cases of typhoid fever are reported in the U.S. annually with most of such cases being brought over from countries where the condition is endemic (Vyas, 2013). Most documented cases involve children and young adults (Burke, 2015). While the infection has no racial preferences, it is strongly linked to race and social-economic status as shown by the fact that it is endemic in poor countries. 80% of cases come from underdeveloped areas in Bangladesh, India, China, Indonesia, Nepal, Laos, Vietnam and Pakistan (Burke, 2015). Furthermore, poor countries do not have good education facilities overall. Thus, typhoid fever is also driven be the fact that populations do not have good education and so may not understand the need for hygiene practices such as good hand hygiene, decontamination of drinking water as well as avoiding practices that contaminate drinking water and food.

Typhoid fever is an infection caused by a bacterium known as Salmonella typhi that results to a febrile condition. The condition has a low fatality rate if treated appropriately but can be fatal is not treated. Common symptoms include diarrhea, fever, constipation, and abdominal pain. Modern estimation of the global burden of typhoid fever is made feasible by the fact that there is data available from national disease surveillance, as well as vaccine and population based studies. Typhoid fever is endemic in poor countries, especially in areas with poor socio-economic status and low education. It is also common among children and young adults.

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