title: Challenges and Opportunities for Typhoid Fever Control: A Call for Coordinated Action.
abstract: The burden of enteric fever caused by Salmonella enterica serovars Typhi and Paratyphi is substantial and has high impact in toddlers and young children. This burden is relatively well documented in Asia, and this supplement provides new data on the substantial burden in several sub-Saharan African countries. Challenges in standardized surveillance and imperfect diagnostic tools have resulted in patchy local disease data, which are not well acknowledged or integrated into local country evidence and health awareness for decision making. There is a need to strengthen diagnostics for the generation of burden data in country. Furthermore, the guidelines and training for treatment of enteric fever cases in Africa are sorely needed to help mitigate the inappropriate use of antimicrobial treatment. Classic water safety and access to sanitation development remain powerful tools for the control of typhoid fever, yet the huge economic costs and long timelines are unlikely to provide a short- to middle-term solution. Emerging threats, including multidrug resistance and increasing urbanization in regions such as sub-Saharan Africa, warrant focused attention to shorter-term interventions including immunization, and must include vaccine strategies with the new typhoid conjugate vaccines.
authors.affiliation: Enteric and Diarrheal Diseases, Bill & Melinda Gates Foundation, Seattle, Washington.
authors.forename: A Duncan
authors.initials: AD
authors.lastname: Steele
authors.affiliation: Enteric and Diarrheal Diseases, Bill & Melinda Gates Foundation, Seattle, Washington.
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Hay Burgess
authors.affiliation: Enteric and Diarrheal Diseases, Bill & Melinda Gates Foundation, Seattle, Washington.
authors.forename: Zoey
authors.initials: Z
authors.lastname: Diaz
authors.affiliation: Enteric and Diarrheal Diseases, Bill & Melinda Gates Foundation, Seattle, Washington.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Carey
authors.affiliation: Enteric and Diarrheal Diseases, Bill & Melinda Gates Foundation, Seattle, Washington.
authors.forename: Anita K M
authors.initials: AK
authors.lastname: Zaidi
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D014943:Global Health; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D062486:Public Health Surveillance; D012485:Salmonella typhi / Q000187:drug effects / Q000472:pathogenicity; D014435:Typhoid Fever / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D014436:Typhoid-Paratyphoid Vaccines; D018074:Vaccines, Conjugate; D055815:Young Adult
chemical_list: D014436:Typhoid-Paratyphoid Vaccines; D018074:Vaccines, Conjugate
keywords: Africa; MDR; WSH; enteric fever; typhoid conjugate vaccines