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The Burden of Typhoid and Paratyphoid in India: Systematic Review and Meta-analysis

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  • Jacob John
  • Carola J C Van Aart
  • Nicholas C Grassly

Abstract

Background: Typhoid is an important public health challenge for India, especially with the spread of antimicrobial resistance. The decision about whether to introduce a public vaccination programme needs to be based on an understanding of disease burden and the age-groups and geographic areas at risk. Methods: We searched Medline and Web of Science databases for studies reporting the incidence or prevalence of typhoid and paratyphoid fever confirmed by culture and/or serology, conducted in India and published between 1950 and 2015. We used binomial and Poisson mixed-effects meta-regression models to estimate prevalence and incidence from hospital and community studies, and to identify risk-factors. Results: We identified 791 titles and abstracts, and included 37 studies of typhoid and 18 studies of paratyphoid in the systematic review and meta-analysis. The estimated prevalence of laboratory-confirmed typhoid and paratyphoid among individuals with fever across all hospital studies was 9.7% (95% CI: 5.7–16.0%) and 0.9% (0.5–1.7%) respectively. There was significant heterogeneity among studies (p-values

Suggested Citation

  • Jacob John & Carola J C Van Aart & Nicholas C Grassly, 2016. "The Burden of Typhoid and Paratyphoid in India: Systematic Review and Meta-analysis," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 10(4), pages 1-14, April.
    • Handle: RePEc:plo:pntd00:0004616
    DOI: 10.1371/journal.pntd.0004616
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