A cross-sectional seroepidemiological survey of typhoid fever in Fiji.
Fiji, an upper-middle income state in the Pacific Ocean, has experienced an increase in confirmed case notifications of enteric fever caused by Salmonella enterica serovar Typhi (S. Typhi). To characterize the epidemiology of typhoid exposure, we conducted a cross-sectional sero-epidemiological surv...
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ftdoajarticles:oai:doaj.org/article:17d924dda15e4e3f832ed5381a262862 2023-05-15T15:16:31+02:00 A cross-sectional seroepidemiological survey of typhoid fever in Fiji. Conall H Watson Stephen Baker Colleen L Lau Kitione Rawalai Mere Taufa Jerimaia Coriakula Nga Tran Vu Thieu Tan Trinh Van Dung Tran Thi Ngoc Niel Hens John H Lowry Ruklanthi de Alwis Jorge Cano Kylie Jenkins E Kim Mulholland Eric J Nilles Mike Kama W John Edmunds 2017-07-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005786 https://doaj.org/article/17d924dda15e4e3f832ed5381a262862 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5549756?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005786 https://doaj.org/article/17d924dda15e4e3f832ed5381a262862 PLoS Neglected Tropical Diseases, Vol 11, Iss 7, p e0005786 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005786 2022-12-31T00:20:15Z Fiji, an upper-middle income state in the Pacific Ocean, has experienced an increase in confirmed case notifications of enteric fever caused by Salmonella enterica serovar Typhi (S. Typhi). To characterize the epidemiology of typhoid exposure, we conducted a cross-sectional sero-epidemiological survey measuring IgG against the Vi antigen of S. Typhi to estimate the effect of age, ethnicity, and other variables on seroprevalence. Epidemiologically relevant cut-off titres were established using a mixed model analysis of data from recovering culture-confirmed typhoid cases. We enrolled and assayed plasma of 1787 participants for anti-Vi IgG; 1,531 of these were resident in mainland areas that had not been previously vaccinated against S. Typhi (seropositivity 32.3% (95%CI 28.2 to 36.3%)), 256 were resident on Taveuni island, which had been previously vaccinated (seropositivity 71.5% (95%CI 62.1 to 80.9%)). The seroprevalence on the Fijian mainland is one to two orders of magnitude higher than expected from confirmed case surveillance incidence, suggesting substantial subclinical or otherwise unreported typhoid. We found no significant differences in seropositivity prevalences by ethnicity, which is in contrast to disease surveillance data in which the indigenous iTaukei Fijian population are disproportionately affected. Using multivariable logistic regression, seropositivity was associated with increased age (odds ratio 1.3 (95% CI 1.2 to 1.4) per 10 years), the presence of a pit latrine (OR 1.6, 95%CI 1.1 to 2.3) as opposed to a septic tank or piped sewer, and residence in settlements rather than residential housing or villages (OR 1.6, 95% CI 1.0 to 2.7). Increasing seropositivity with age is suggestive of low-level endemic transmission in Fiji. Improved sanitation where pit latrines are used and addressing potential transmission routes in settlements may reduce exposure to S. Typhi. Widespread unreported infection suggests there may be a role for typhoid vaccination in Fiji, in addition to public health ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Pacific PLOS Neglected Tropical Diseases 11 7 e0005786 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Conall H Watson Stephen Baker Colleen L Lau Kitione Rawalai Mere Taufa Jerimaia Coriakula Nga Tran Vu Thieu Tan Trinh Van Dung Tran Thi Ngoc Niel Hens John H Lowry Ruklanthi de Alwis Jorge Cano Kylie Jenkins E Kim Mulholland Eric J Nilles Mike Kama W John Edmunds A cross-sectional seroepidemiological survey of typhoid fever in Fiji. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Fiji, an upper-middle income state in the Pacific Ocean, has experienced an increase in confirmed case notifications of enteric fever caused by Salmonella enterica serovar Typhi (S. Typhi). To characterize the epidemiology of typhoid exposure, we conducted a cross-sectional sero-epidemiological survey measuring IgG against the Vi antigen of S. Typhi to estimate the effect of age, ethnicity, and other variables on seroprevalence. Epidemiologically relevant cut-off titres were established using a mixed model analysis of data from recovering culture-confirmed typhoid cases. We enrolled and assayed plasma of 1787 participants for anti-Vi IgG; 1,531 of these were resident in mainland areas that had not been previously vaccinated against S. Typhi (seropositivity 32.3% (95%CI 28.2 to 36.3%)), 256 were resident on Taveuni island, which had been previously vaccinated (seropositivity 71.5% (95%CI 62.1 to 80.9%)). The seroprevalence on the Fijian mainland is one to two orders of magnitude higher than expected from confirmed case surveillance incidence, suggesting substantial subclinical or otherwise unreported typhoid. We found no significant differences in seropositivity prevalences by ethnicity, which is in contrast to disease surveillance data in which the indigenous iTaukei Fijian population are disproportionately affected. Using multivariable logistic regression, seropositivity was associated with increased age (odds ratio 1.3 (95% CI 1.2 to 1.4) per 10 years), the presence of a pit latrine (OR 1.6, 95%CI 1.1 to 2.3) as opposed to a septic tank or piped sewer, and residence in settlements rather than residential housing or villages (OR 1.6, 95% CI 1.0 to 2.7). Increasing seropositivity with age is suggestive of low-level endemic transmission in Fiji. Improved sanitation where pit latrines are used and addressing potential transmission routes in settlements may reduce exposure to S. Typhi. Widespread unreported infection suggests there may be a role for typhoid vaccination in Fiji, in addition to public health ... |
format |
Article in Journal/Newspaper |
author |
Conall H Watson Stephen Baker Colleen L Lau Kitione Rawalai Mere Taufa Jerimaia Coriakula Nga Tran Vu Thieu Tan Trinh Van Dung Tran Thi Ngoc Niel Hens John H Lowry Ruklanthi de Alwis Jorge Cano Kylie Jenkins E Kim Mulholland Eric J Nilles Mike Kama W John Edmunds |
author_facet |
Conall H Watson Stephen Baker Colleen L Lau Kitione Rawalai Mere Taufa Jerimaia Coriakula Nga Tran Vu Thieu Tan Trinh Van Dung Tran Thi Ngoc Niel Hens John H Lowry Ruklanthi de Alwis Jorge Cano Kylie Jenkins E Kim Mulholland Eric J Nilles Mike Kama W John Edmunds |
author_sort |
Conall H Watson |
title |
A cross-sectional seroepidemiological survey of typhoid fever in Fiji. |
title_short |
A cross-sectional seroepidemiological survey of typhoid fever in Fiji. |
title_full |
A cross-sectional seroepidemiological survey of typhoid fever in Fiji. |
title_fullStr |
A cross-sectional seroepidemiological survey of typhoid fever in Fiji. |
title_full_unstemmed |
A cross-sectional seroepidemiological survey of typhoid fever in Fiji. |
title_sort |
cross-sectional seroepidemiological survey of typhoid fever in fiji. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005786 https://doaj.org/article/17d924dda15e4e3f832ed5381a262862 |
geographic |
Arctic Pacific |
geographic_facet |
Arctic Pacific |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 7, p e0005786 (2017) |
op_relation |
http://europepmc.org/articles/PMC5549756?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005786 https://doaj.org/article/17d924dda15e4e3f832ed5381a262862 |
op_doi |
https://doi.org/10.1371/journal.pntd.0005786 |
container_title |
PLOS Neglected Tropical Diseases |
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11 |
container_issue |
7 |
container_start_page |
e0005786 |
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1766346812373860352 |