The burden and characteristics of enteric fever at a healthcare facility in a densely populated area of Kathmandu

Karkey, A, Arjyal, A, Anders, KL, Boni, MF, Dongol, S, Koirala, S, Phan, VTM, Tran, VTN, Clements, ACA, Holt, KE, Pham, TD, Day, JN, Campbell, JI, Dougan, G, Dolecek, C, Farrar, J, Basnyat, B and Baker, S (2010) The burden and characteristics of enteric fever at a healthcare facility in a densely populated area of Kathmandu. PLoS ONE, 5 11: e13988-1-e13988-8. doi:10.1371/journal.pone.0013988

Author Karkey, A
Arjyal, A
Anders, KL
Boni, MF
Dongol, S
Koirala, S
Phan, VTM
Tran, VTN
Clements, ACA
Holt, KE
Pham, TD
Day, JN
Campbell, JI
Dougan, G
Dolecek, C
Farrar, J
Basnyat, B
Baker, S
Title The burden and characteristics of enteric fever at a healthcare facility in a densely populated area of Kathmandu
Journal name PLoS ONE   Check publisher's open access policy
ISSN 1932-6203
Publication date 2010-11-01
Sub-type Article (original research)
DOI 10.1371/journal.pone.0013988
Open Access Status DOI
Volume 5
Issue 11
Start page e13988-1
End page e13988-8
Total pages 8
Place of publication San Francisco, CA, United States
Publisher Public Library of Science
Language eng
Formatted abstract
Enteric fever, caused by Salmonella enterica serovars Typhi and Paratyphi A (S. Typhi and S. Paratyphi A) remains a major public health problem in many settings. The disease is limited to locations with poor sanitation which facilitates the transmission of the infecting organisms. Efficacious and inexpensive vaccines are available for S. Typhi, yet are not commonly deployed to control the disease. Lack of vaccination is due partly to uncertainty of the disease burden arising from a paucity of epidemiological information in key locations. We have collected and analyzed data from 3,898 cases of blood culture-confirmed enteric fever from Patan Hospital in Lalitpur Sub-Metropolitan City (LSMC), between June 2005 and May 2009. Demographic data was available for a subset of these patients (n = 527) that were resident in LSMC and who were enrolled in trials. We show a considerable burden of enteric fever caused by S. Typhi (2,672; 68.5%) and S. Paratyphi A (1,226; 31.5%) at this Hospital over a four year period, which correlate with seasonal fluctuations in rainfall. We found that local population density was not related to incidence and we identified a focus of infections in the east of LSMC. With data from patients resident in LSMC we found that the median age of those with S. Typhi (16 years) was significantly less than S. Paratyphi A (20 years) and that males aged 15 to 25 were disproportionately infected. Our findings provide a snapshot into the epidemiological patterns of enteric fever in Kathmandu. The uneven distribution of enteric fever patients within the population suggests local variation in risk factors, such as contaminated drinking water. These findings are important for initiating a vaccination scheme and improvements in sanitation. We suggest any such intervention should be implemented throughout the LSMC area. © 2010 Karkey et al.
Keyword Typhoid-fever
Paratyphoid fever
Effectiveness trial
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article # e13988

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 23 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 26 times in Scopus Article | Citations
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Created: Sun, 05 Dec 2010, 10:02:44 EST