Typhoid Fever in South Africa in an Endemic HIV Setting
Typhoid fever remains an important disease in Africa, associated with outbreaks and the emerging multidrug resistant Salmonella enterica serotype Typhi (Salmonella Typhi) haplotype, H58. This study describes the incidence of, and factors associated with mortality due to, typhoid fever in South Afric...
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| creator | Keddy, Karen H Sooka, Arvinda Smith, Anthony M Musekiwa, Alfred Tau, Nomsa P Klugman, Keith P Angulo, Frederick J |
| description | Typhoid fever remains an important disease in Africa, associated with outbreaks and the emerging multidrug resistant Salmonella enterica serotype Typhi (Salmonella Typhi) haplotype, H58. This study describes the incidence of, and factors associated with mortality due to, typhoid fever in South Africa, where HIV prevalence is high.
Nationwide active laboratory-based surveillance for culture-confirmed typhoid fever was undertaken from 2003-2013. At selected institutions, additional clinical data from patients were collected including age, sex, HIV status, disease severity and outcome. HIV prevalence among typhoid fever patients was compared to national HIV seroprevalence estimates. The national reference laboratory tested Salmonella Typhi isolates for antimicrobial susceptibility and haplotype. Unadjusted and adjusted logistic regression analyses were conducted determining factors associated with typhoid fever mortality. We identified 855 typhoid fever cases: annual incidence ranged from 0.11 to 0.39 per 100,000 population. Additional clinical data were available for 369 (46.8%) cases presenting to the selected sites. Among typhoid fever patients with known HIV status, 19.3% (29/150) were HIV-infected. In adult females, HIV prevalence in typhoid fever patients was 43.2% (19/44) versus 15.7% national HIV seroprevalence (P < .001); in adult males, 16.3% (7/43) versus 12.3% national HIV seroprevalence (P = .2). H58 represented 11.9% (22/185) of Salmonella Typhi isolates tested. Increased mortality was associated with HIV infection (AOR 10.7; 95% CI 2.3-50.3) and disease severity (AOR 9.8; 95% CI 1.6-60.0) on multivariate analysis.
Typhoid fever incidence in South Africa was largely unchanged from 2003-2013. Typhoid fever mortality was associated disease severity. HIV infection may be a contributing factor. Interventions mandate improved health care access, including to HIV management programmes as well as patient education. Further studies are necessary to clarify relationships between HIV infection and typhoid fever in adults. |
| doi_str_mv | 10.1371/journal.pone.0164939 |
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Nationwide active laboratory-based surveillance for culture-confirmed typhoid fever was undertaken from 2003-2013. At selected institutions, additional clinical data from patients were collected including age, sex, HIV status, disease severity and outcome. HIV prevalence among typhoid fever patients was compared to national HIV seroprevalence estimates. The national reference laboratory tested Salmonella Typhi isolates for antimicrobial susceptibility and haplotype. Unadjusted and adjusted logistic regression analyses were conducted determining factors associated with typhoid fever mortality. We identified 855 typhoid fever cases: annual incidence ranged from 0.11 to 0.39 per 100,000 population. Additional clinical data were available for 369 (46.8%) cases presenting to the selected sites. Among typhoid fever patients with known HIV status, 19.3% (29/150) were HIV-infected. In adult females, HIV prevalence in typhoid fever patients was 43.2% (19/44) versus 15.7% national HIV seroprevalence (P < .001); in adult males, 16.3% (7/43) versus 12.3% national HIV seroprevalence (P = .2). H58 represented 11.9% (22/185) of Salmonella Typhi isolates tested. Increased mortality was associated with HIV infection (AOR 10.7; 95% CI 2.3-50.3) and disease severity (AOR 9.8; 95% CI 1.6-60.0) on multivariate analysis.
Typhoid fever incidence in South Africa was largely unchanged from 2003-2013. Typhoid fever mortality was associated disease severity. HIV infection may be a contributing factor. Interventions mandate improved health care access, including to HIV management programmes as well as patient education. Further studies are necessary to clarify relationships between HIV infection and typhoid fever in adults.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0164939</identifier><identifier>PMID: 27780232</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adolescent ; Adult ; Adults ; AIDS ; Analysis ; Biology and Life Sciences ; Child ; Child, Preschool ; Disease control ; Drug resistance ; Endemic Diseases ; Female ; Females ; Fever ; Haplotypes ; Health care ; Health care reform ; Health sciences ; HIV ; HIV infections ; HIV Infections - epidemiology ; HIV patients ; Human immunodeficiency virus ; Humans ; Incidence ; Infant ; Infections ; Laboratories ; Lentivirus ; Logistic Models ; Male ; Males ; Medical research ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Multidrug resistance ; Multivariate analysis ; Outbreaks ; Patient education ; Patients ; People and places ; Public health ; Regression analysis ; Retroviridae ; Salmonella ; Salmonella enterica ; Salmonella typhi ; Serology ; Sexually transmitted diseases ; South Africa - epidemiology ; STD ; Typhoid ; Typhoid fever ; Typhoid Fever - epidemiology ; Typhoid Fever - mortality ; Waterborne diseases ; Young Adult</subject><ispartof>PloS one, 2016-10, Vol.11 (10), p.e0164939-e0164939</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-d8b8c6cb6fb0008acb8d23d8095e6e5102a7465630b3ead6f1769db4b14d25493</citedby><cites>FETCH-LOGICAL-c725t-d8b8c6cb6fb0008acb8d23d8095e6e5102a7465630b3ead6f1769db4b14d25493</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5079545/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5079545/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27780232$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Chakravortty, Dipshikha</contributor><creatorcontrib>Keddy, Karen H</creatorcontrib><creatorcontrib>Sooka, Arvinda</creatorcontrib><creatorcontrib>Smith, Anthony M</creatorcontrib><creatorcontrib>Musekiwa, Alfred</creatorcontrib><creatorcontrib>Tau, Nomsa P</creatorcontrib><creatorcontrib>Klugman, Keith P</creatorcontrib><creatorcontrib>Angulo, Frederick J</creatorcontrib><creatorcontrib>GERMS-SA</creatorcontrib><creatorcontrib>GERMS-SA</creatorcontrib><title>Typhoid Fever in South Africa in an Endemic HIV Setting</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Typhoid fever remains an important disease in Africa, associated with outbreaks and the emerging multidrug resistant Salmonella enterica serotype Typhi (Salmonella Typhi) haplotype, H58. This study describes the incidence of, and factors associated with mortality due to, typhoid fever in South Africa, where HIV prevalence is high.
Nationwide active laboratory-based surveillance for culture-confirmed typhoid fever was undertaken from 2003-2013. At selected institutions, additional clinical data from patients were collected including age, sex, HIV status, disease severity and outcome. HIV prevalence among typhoid fever patients was compared to national HIV seroprevalence estimates. The national reference laboratory tested Salmonella Typhi isolates for antimicrobial susceptibility and haplotype. Unadjusted and adjusted logistic regression analyses were conducted determining factors associated with typhoid fever mortality. We identified 855 typhoid fever cases: annual incidence ranged from 0.11 to 0.39 per 100,000 population. Additional clinical data were available for 369 (46.8%) cases presenting to the selected sites. Among typhoid fever patients with known HIV status, 19.3% (29/150) were HIV-infected. In adult females, HIV prevalence in typhoid fever patients was 43.2% (19/44) versus 15.7% national HIV seroprevalence (P < .001); in adult males, 16.3% (7/43) versus 12.3% national HIV seroprevalence (P = .2). H58 represented 11.9% (22/185) of Salmonella Typhi isolates tested. Increased mortality was associated with HIV infection (AOR 10.7; 95% CI 2.3-50.3) and disease severity (AOR 9.8; 95% CI 1.6-60.0) on multivariate analysis.
Typhoid fever incidence in South Africa was largely unchanged from 2003-2013. Typhoid fever mortality was associated disease severity. HIV infection may be a contributing factor. Interventions mandate improved health care access, including to HIV management programmes as well as patient education. Further studies are necessary to clarify relationships between HIV infection and typhoid fever in adults.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>AIDS</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Disease control</subject><subject>Drug resistance</subject><subject>Endemic Diseases</subject><subject>Female</subject><subject>Females</subject><subject>Fever</subject><subject>Haplotypes</subject><subject>Health care</subject><subject>Health care reform</subject><subject>Health sciences</subject><subject>HIV</subject><subject>HIV infections</subject><subject>HIV Infections - epidemiology</subject><subject>HIV patients</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infections</subject><subject>Laboratories</subject><subject>Lentivirus</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Males</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multidrug resistance</subject><subject>Multivariate analysis</subject><subject>Outbreaks</subject><subject>Patient education</subject><subject>Patients</subject><subject>People and places</subject><subject>Public health</subject><subject>Regression analysis</subject><subject>Retroviridae</subject><subject>Salmonella</subject><subject>Salmonella enterica</subject><subject>Salmonella typhi</subject><subject>Serology</subject><subject>Sexually transmitted diseases</subject><subject>South Africa - epidemiology</subject><subject>STD</subject><subject>Typhoid</subject><subject>Typhoid fever</subject><subject>Typhoid Fever - epidemiology</subject><subject>Typhoid Fever - mortality</subject><subject>Waterborne diseases</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk01rGzEQhpfS0qRp_0FpFwqlPdjVx-rrUjAhaQyBQJ3mKrSS1lZYrxxJG5p_X9neBG_JIeggafTMK82Mpig-QjCFmMEft74PnWqnG9_ZKYC0Eli8Ko6hwGhCEcCvD9ZHxbsYbwEgmFP6tjhCjHGAMDou2PXDZuWdKc_tvQ2l68qF79OqnDXBabXdq64864xdO11ezG_KhU3Jdcv3xZtGtdF-GOaT4s_52fXpxeTy6tf8dHY50QyRNDG85prqmjY1AIArXXODsOFAEEstgQApVlFCMaixVYY2kFFh6qqGlUEkh3RSfN7rblof5RBzlJBjhCARjGdivieMV7dyE9xahQfplZM7gw9LqUJyurXSUmaFQQJpDCtQccFFRWpKGkEYpgpmrZ_DbX29tkbbLgXVjkTHJ51byaW_lwQwQSqSBb4NAsHf9TYmuXZR27ZVnfX97t0MYwI4fAlKKKMVARn98h_6fCIGaqlyrK5rfH6i3orKWcWgyAGD7bXTZ6g8diXOf6lx2T5y-D5yyEyyf9NS9THK-eL3y9mrmzH79YBdWdWmVfRtn5zv4his9qAOPsZgm6d6QCC3rfCYDbltBTm0Qnb7dFjLJ6fHv4__Acch_vo</recordid><startdate>20161025</startdate><enddate>20161025</enddate><creator>Keddy, Karen H</creator><creator>Sooka, Arvinda</creator><creator>Smith, Anthony M</creator><creator>Musekiwa, Alfred</creator><creator>Tau, Nomsa P</creator><creator>Klugman, Keith P</creator><creator>Angulo, Frederick J</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20161025</creationdate><title>Typhoid Fever in South Africa in an Endemic HIV Setting</title><author>Keddy, Karen H ; Sooka, Arvinda ; Smith, Anthony M ; Musekiwa, Alfred ; Tau, Nomsa P ; Klugman, Keith P ; Angulo, Frederick J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c725t-d8b8c6cb6fb0008acb8d23d8095e6e5102a7465630b3ead6f1769db4b14d25493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Adults</topic><topic>AIDS</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Disease control</topic><topic>Drug resistance</topic><topic>Endemic Diseases</topic><topic>Female</topic><topic>Females</topic><topic>Fever</topic><topic>Haplotypes</topic><topic>Health care</topic><topic>Health care reform</topic><topic>Health sciences</topic><topic>HIV</topic><topic>HIV infections</topic><topic>HIV Infections - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Keddy, Karen H</au><au>Sooka, Arvinda</au><au>Smith, Anthony M</au><au>Musekiwa, Alfred</au><au>Tau, Nomsa P</au><au>Klugman, Keith P</au><au>Angulo, Frederick J</au><au>Chakravortty, Dipshikha</au><aucorp>GERMS-SA</aucorp><aucorp>GERMS-SA</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Typhoid Fever in South Africa in an Endemic HIV Setting</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-10-25</date><risdate>2016</risdate><volume>11</volume><issue>10</issue><spage>e0164939</spage><epage>e0164939</epage><pages>e0164939-e0164939</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Typhoid fever remains an important disease in Africa, associated with outbreaks and the emerging multidrug resistant Salmonella enterica serotype Typhi (Salmonella Typhi) haplotype, H58. This study describes the incidence of, and factors associated with mortality due to, typhoid fever in South Africa, where HIV prevalence is high.
Nationwide active laboratory-based surveillance for culture-confirmed typhoid fever was undertaken from 2003-2013. At selected institutions, additional clinical data from patients were collected including age, sex, HIV status, disease severity and outcome. HIV prevalence among typhoid fever patients was compared to national HIV seroprevalence estimates. The national reference laboratory tested Salmonella Typhi isolates for antimicrobial susceptibility and haplotype. Unadjusted and adjusted logistic regression analyses were conducted determining factors associated with typhoid fever mortality. We identified 855 typhoid fever cases: annual incidence ranged from 0.11 to 0.39 per 100,000 population. Additional clinical data were available for 369 (46.8%) cases presenting to the selected sites. Among typhoid fever patients with known HIV status, 19.3% (29/150) were HIV-infected. In adult females, HIV prevalence in typhoid fever patients was 43.2% (19/44) versus 15.7% national HIV seroprevalence (P < .001); in adult males, 16.3% (7/43) versus 12.3% national HIV seroprevalence (P = .2). H58 represented 11.9% (22/185) of Salmonella Typhi isolates tested. Increased mortality was associated with HIV infection (AOR 10.7; 95% CI 2.3-50.3) and disease severity (AOR 9.8; 95% CI 1.6-60.0) on multivariate analysis.
Typhoid fever incidence in South Africa was largely unchanged from 2003-2013. Typhoid fever mortality was associated disease severity. HIV infection may be a contributing factor. Interventions mandate improved health care access, including to HIV management programmes as well as patient education. Further studies are necessary to clarify relationships between HIV infection and typhoid fever in adults.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27780232</pmid><doi>10.1371/journal.pone.0164939</doi><tpages>e0164939</tpages><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_plos_journals_1832215978 |
| source | PLoS; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Adolescent Adult Adults AIDS Analysis Biology and Life Sciences Child Child, Preschool Disease control Drug resistance Endemic Diseases Female Females Fever Haplotypes Health care Health care reform Health sciences HIV HIV infections HIV Infections - epidemiology HIV patients Human immunodeficiency virus Humans Incidence Infant Infections Laboratories Lentivirus Logistic Models Male Males Medical research Medicine and Health Sciences Middle Aged Mortality Multidrug resistance Multivariate analysis Outbreaks Patient education Patients People and places Public health Regression analysis Retroviridae Salmonella Salmonella enterica Salmonella typhi Serology Sexually transmitted diseases South Africa - epidemiology STD Typhoid Typhoid fever Typhoid Fever - epidemiology Typhoid Fever - mortality Waterborne diseases Young Adult |
| title | Typhoid Fever in South Africa in an Endemic HIV Setting |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T10%3A18%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Typhoid%20Fever%20in%20South%20Africa%20in%20an%20Endemic%20HIV%20Setting&rft.jtitle=PloS%20one&rft.au=Keddy,%20Karen%20H&rft.aucorp=GERMS-SA&rft.date=2016-10-25&rft.volume=11&rft.issue=10&rft.spage=e0164939&rft.epage=e0164939&rft.pages=e0164939-e0164939&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0164939&rft_dat=%3Cgale_plos_%3EA471904801%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1832215978&rft_id=info:pmid/27780232&rft_galeid=A471904801&rft_doaj_id=oai_doaj_org_article_e67e9d292c31404898945b65f95736a1&rfr_iscdi=true |