Facility-based disease surveillance and Bayesian hierarchical modeling to estimate endemic typhoid fever incidence, Kilimanjaro Region, Tanzania, 2007-2018.
Growing evidence suggests considerable variation in endemic typhoid fever incidence at some locations over time, yet few settings have multi-year incidence estimates to inform typhoid control measures. We sought to describe a decade of typhoid fever incidence in the Kilimanjaro Region of Tanzania. C...
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ftdoajarticles:oai:doaj.org/article:9bbc14b649184667abe5adf72ebe90a0 2023-05-15T15:11:42+02:00 Facility-based disease surveillance and Bayesian hierarchical modeling to estimate endemic typhoid fever incidence, Kilimanjaro Region, Tanzania, 2007-2018. Elena R Cutting Ryan A Simmons Deng B Madut Michael J Maze Nathaniel H Kalengo Manuela Carugati Ronald M Mbwasi Kajiru G Kilonzo Furaha Lyamuya Annette Marandu Calvin Mosha Wilbrod Saganda Bingileki F Lwezaula Julian T Hertz Anne B Morrissey Elizabeth L Turner Blandina T Mmbaga Grace D Kinabo Venance P Maro John A Crump Matthew P Rubach 2022-07-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0010516 https://doaj.org/article/9bbc14b649184667abe5adf72ebe90a0 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0010516 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010516 https://doaj.org/article/9bbc14b649184667abe5adf72ebe90a0 PLoS Neglected Tropical Diseases, Vol 16, Iss 7, p e0010516 (2022) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2022 ftdoajarticles https://doi.org/10.1371/journal.pntd.0010516 2022-12-30T23:47:38Z Growing evidence suggests considerable variation in endemic typhoid fever incidence at some locations over time, yet few settings have multi-year incidence estimates to inform typhoid control measures. We sought to describe a decade of typhoid fever incidence in the Kilimanjaro Region of Tanzania. Cases of blood culture confirmed typhoid were identified among febrile patients at two sentinel hospitals during three study periods: 2007-08, 2011-14, and 2016-18. To account for under-ascertainment at sentinel facilities, we derived adjustment multipliers from healthcare utilization surveys done in the hospital catchment area. Incidence estimates and credible intervals (CrI) were derived using a Bayesian hierarchical incidence model that incorporated uncertainty of our observed typhoid fever prevalence, of healthcare seeking adjustment multipliers, and of blood culture diagnostic sensitivity. Among 3,556 total participants, 50 typhoid fever cases were identified. Of typhoid cases, 26 (52%) were male and the median (range) age was 22 (<1-60) years; 4 (8%) were aged <5 years and 10 (20%) were aged 5 to 14 years. Annual typhoid fever incidence was estimated as 61.5 (95% CrI 14.9-181.9), 6.5 (95% CrI 1.4-20.4), and 4.0 (95% CrI 0.6-13.9) per 100,000 persons in 2007-08, 2011-14, and 2016-18, respectively. There were no deaths among typhoid cases. We estimated moderate typhoid incidence (≥10 per 100 000) in 2007-08 and low (<10 per 100 000) incidence during later surveillance periods, but with overlapping credible intervals across study periods. Although consistent with falling typhoid incidence, we interpret this as showing substantial variation over the study periods. Given potential variation, multi-year surveillance may be warranted in locations making decisions about typhoid conjugate vaccine introduction and other control measures. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 16 7 e0010516 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
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 Elena R Cutting Ryan A Simmons Deng B Madut Michael J Maze Nathaniel H Kalengo Manuela Carugati Ronald M Mbwasi Kajiru G Kilonzo Furaha Lyamuya Annette Marandu Calvin Mosha Wilbrod Saganda Bingileki F Lwezaula Julian T Hertz Anne B Morrissey Elizabeth L Turner Blandina T Mmbaga Grace D Kinabo Venance P Maro John A Crump Matthew P Rubach Facility-based disease surveillance and Bayesian hierarchical modeling to estimate endemic typhoid fever incidence, Kilimanjaro Region, Tanzania, 2007-2018. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Growing evidence suggests considerable variation in endemic typhoid fever incidence at some locations over time, yet few settings have multi-year incidence estimates to inform typhoid control measures. We sought to describe a decade of typhoid fever incidence in the Kilimanjaro Region of Tanzania. Cases of blood culture confirmed typhoid were identified among febrile patients at two sentinel hospitals during three study periods: 2007-08, 2011-14, and 2016-18. To account for under-ascertainment at sentinel facilities, we derived adjustment multipliers from healthcare utilization surveys done in the hospital catchment area. Incidence estimates and credible intervals (CrI) were derived using a Bayesian hierarchical incidence model that incorporated uncertainty of our observed typhoid fever prevalence, of healthcare seeking adjustment multipliers, and of blood culture diagnostic sensitivity. Among 3,556 total participants, 50 typhoid fever cases were identified. Of typhoid cases, 26 (52%) were male and the median (range) age was 22 (<1-60) years; 4 (8%) were aged <5 years and 10 (20%) were aged 5 to 14 years. Annual typhoid fever incidence was estimated as 61.5 (95% CrI 14.9-181.9), 6.5 (95% CrI 1.4-20.4), and 4.0 (95% CrI 0.6-13.9) per 100,000 persons in 2007-08, 2011-14, and 2016-18, respectively. There were no deaths among typhoid cases. We estimated moderate typhoid incidence (≥10 per 100 000) in 2007-08 and low (<10 per 100 000) incidence during later surveillance periods, but with overlapping credible intervals across study periods. Although consistent with falling typhoid incidence, we interpret this as showing substantial variation over the study periods. Given potential variation, multi-year surveillance may be warranted in locations making decisions about typhoid conjugate vaccine introduction and other control measures. |
format |
Article in Journal/Newspaper |
author |
Elena R Cutting Ryan A Simmons Deng B Madut Michael J Maze Nathaniel H Kalengo Manuela Carugati Ronald M Mbwasi Kajiru G Kilonzo Furaha Lyamuya Annette Marandu Calvin Mosha Wilbrod Saganda Bingileki F Lwezaula Julian T Hertz Anne B Morrissey Elizabeth L Turner Blandina T Mmbaga Grace D Kinabo Venance P Maro John A Crump Matthew P Rubach |
author_facet |
Elena R Cutting Ryan A Simmons Deng B Madut Michael J Maze Nathaniel H Kalengo Manuela Carugati Ronald M Mbwasi Kajiru G Kilonzo Furaha Lyamuya Annette Marandu Calvin Mosha Wilbrod Saganda Bingileki F Lwezaula Julian T Hertz Anne B Morrissey Elizabeth L Turner Blandina T Mmbaga Grace D Kinabo Venance P Maro John A Crump Matthew P Rubach |
author_sort |
Elena R Cutting |
title |
Facility-based disease surveillance and Bayesian hierarchical modeling to estimate endemic typhoid fever incidence, Kilimanjaro Region, Tanzania, 2007-2018. |
title_short |
Facility-based disease surveillance and Bayesian hierarchical modeling to estimate endemic typhoid fever incidence, Kilimanjaro Region, Tanzania, 2007-2018. |
title_full |
Facility-based disease surveillance and Bayesian hierarchical modeling to estimate endemic typhoid fever incidence, Kilimanjaro Region, Tanzania, 2007-2018. |
title_fullStr |
Facility-based disease surveillance and Bayesian hierarchical modeling to estimate endemic typhoid fever incidence, Kilimanjaro Region, Tanzania, 2007-2018. |
title_full_unstemmed |
Facility-based disease surveillance and Bayesian hierarchical modeling to estimate endemic typhoid fever incidence, Kilimanjaro Region, Tanzania, 2007-2018. |
title_sort |
facility-based disease surveillance and bayesian hierarchical modeling to estimate endemic typhoid fever incidence, kilimanjaro region, tanzania, 2007-2018. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2022 |
url |
https://doi.org/10.1371/journal.pntd.0010516 https://doaj.org/article/9bbc14b649184667abe5adf72ebe90a0 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 16, Iss 7, p e0010516 (2022) |
op_relation |
https://doi.org/10.1371/journal.pntd.0010516 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010516 https://doaj.org/article/9bbc14b649184667abe5adf72ebe90a0 |
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https://doi.org/10.1371/journal.pntd.0010516 |
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PLOS Neglected Tropical Diseases |
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16 |
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7 |
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e0010516 |
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