title: The malaria and typhoid fever burden in the slums of Kolkata, India: data from a prospective community-based study.
abstract: Recent research has indicated that the malaria burden in Asia may have been vastly underestimated. We conducted a prospective community-based study in an impoverished urban site in Kolkata, India, to estimate the burden of malaria and typhoid fever and to identify risk factors for these diseases. In a population of 60452 people, 3605 fever episodes were detected over a 12-month period. The blood films of 93 febrile patients contained Plasmodium (90 P. vivax, 2 P. falciparum and 1 P. malariae). Blood cultures from 95 patients grew Salmonella enterica serotype Typhi. Malaria patients were found to be significantly older (mean age 29 years) compared with patients with typhoid fever (15 years; P<0.001) but had similar clinical features on presentation. Having a household member with malaria, illiteracy, low household income and living in a structure not built of bricks were associated with an increased risk for malaria. Having a household member with typhoid fever and poor hygiene were associated with typhoid fever. A geographic analysis of the spatial distribution of malaria and typhoid fever cases detected high-risk neighbourhoods for each disease. Focal interventions to minimise human-vector contact and improved personal hygiene and targeted vaccination campaigns could help to prevent malaria and typhoid fever in this site.
authors.affiliation: National Institute of Cholera and Enteric Diseases, P-33 CIT Rd. Scheme - XM, Beliaghata, Kolkata 700010, India.
authors.forename: Dipika
authors.initials: D
authors.lastname: Sur
authors.forename: Lorenz
authors.initials: L
authors.lastname: von Seidlein
authors.forename: Byomkesh
authors.initials: B
authors.lastname: Manna
authors.forename: Shanta
authors.initials: S
authors.lastname: Dutta
authors.forename: Alok K
authors.initials: AK
authors.lastname: Deb
authors.forename: Banwari Lal
authors.initials: BL
authors.lastname: Sarkar
authors.forename: Suman
authors.initials: S
authors.lastname: Kanungo
authors.forename: Jacqueline L
authors.initials: JL
authors.lastname: Deen
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ali
authors.forename: Deok Ryun
authors.initials: DR
authors.lastname: Kim
authors.forename: Vinay Kumar
authors.initials: VK
authors.lastname: Gupta
authors.forename: R Leon
authors.initials: RL
authors.lastname: Ochiai
authors.forename: Ataru
authors.initials: A
authors.lastname: Tsuzuki
authors.forename: Camilo J
authors.initials: CJ
authors.lastname: Acosta
authors.forename: John D
authors.initials: JD
authors.lastname: Clemens
authors.forename: Sujit K
authors.initials: SK
authors.lastname: Bhattacharya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008288:Malaria / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011204:Poverty Areas; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D014435:Typhoid Fever / Q000453:epidemiology*; D014504:Urban Health