title: Burden of typhoid fever in Sulaimania, Iraqi Kurdistan.
abstract: BACKGROUND
  Typhoid fever imposes a high disease burden worldwide, but resource limitations mean that the burden of typhoid fever in many countries is poorly understood.
  
  
  METHODS
  The authors conducted a prospective surveillance study at the adult and pediatric teaching hospitals in Sulaimania, Iraqi Kurdistan. All patients presenting with an undifferentiated febrile illness consistent with typhoid were eligible for enrollment. Enrolled patients had blood cultures and Brucella serologies performed. Incidence was calculated with reference to census data.
  
  
  RESULTS
  Both typhoid fever and brucellosis were common, and the incidence of typhoid fever was 21 cases/100 000 patient-years. Classic disease symptoms were uncommonly observed.
  
  
  CONCLUSIONS
  Cost-effective surveillance projects to calculate disease burden of typhoid fever are practical and replicable. Typhoid has successfully adapted to the healthcare environment in Sulaimania. Additional work in the region should focus on antibiotic resistance and other enteric pathogens such as Brucella spp.
authors.affiliation: John A. Burns School of Medicine, University of Hawaii, 1380 Lusitania St, Suite 904, Honolulu, HI 96813, USA. Electronic address: jdworkin@hotmail.com.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dworkin
authors.affiliation: General University Teaching Hospital of Sulaimania, Sulaimania, Kurdistan.
authors.forename: Rebeen
authors.initials: R
authors.lastname: Saeed
authors.affiliation: General University Teaching Hospital of Sulaimania, Sulaimania, Kurdistan.
authors.forename: Hawar
authors.initials: H
authors.lastname: Mykhan
authors.affiliation: General Pediatric Teaching Hospital of Sulaimania, Sulaimania, Kurdistan.
authors.forename: Shwan
authors.initials: S
authors.lastname: Kanan
authors.affiliation: General University Teaching Hospital of Sulaimania, Sulaimania, Kurdistan.
authors.forename: Dlawer
authors.initials: D
authors.lastname: Farhad
authors.affiliation: General Pediatric Teaching Hospital of Sulaimania, Sulaimania, Kurdistan.
authors.forename: Kocher Omer
authors.initials: KO
authors.lastname: Ali
authors.affiliation: Central Laboratory of Sulaimania, Sulaimania, Kurdistan.
authors.forename: Runak Hama Kareem
authors.initials: RH
authors.lastname: Abdulwahab
authors.affiliation: Memorial Hospital of Rhode Island, Pawtucket, Rhode Island, USA.
authors.forename: John
authors.initials: J
authors.lastname: Palardy
authors.affiliation: Memorial Hospital of Rhode Island, Pawtucket, Rhode Island, USA; Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
authors.forename: Marguerite A
authors.initials: MA
authors.lastname: Neill
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002006:Brucellosis / Q000097:blood / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007493:Iraq / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D014435:Typhoid Fever / Q000097:blood / Q000453:epidemiology*; D055815:Young Adult
keywords: Brucella; Burden of Disease; Incidence; Iraq; Kurdistan; Typhoid