scholarly journals Why Is Eradicating Typhoid Fever So Challenging: Implications for Vaccine and Therapeutic Design

Vaccines ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 45 ◽  
Author(s):  
Yi-An Yang ◽  
Alexander Chong ◽  
Jeongmin Song
Keyword(s):  
Typhoid Fever ◽  
Treatment Strategies ◽  
Significant Risk ◽  
Multidrug Resistant ◽  
Middle Income ◽  
Salmonella Enterica Serovar Typhi ◽  
Middle Income Countries ◽  
Extensively Drug Resistant ◽  
Typhoid Vaccines ◽  
Do So

Salmonella enterica serovar Typhi (S. Typhi) and S. Paratyphi, namely typhoidal Salmonellae, are the cause of (para) typhoid fever, which is a devastating systemic infectious disease in humans. In addition, the spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) S. Typhi in many low and middle-income countries poses a significant risk to human health. While currently available typhoid vaccines and therapeutics are efficacious, they have some limitations. One important limitation is the lack of controlling individuals who chronically carry S. Typhi. However, due to the strict host specificity of S. Typhi to humans, S. Typhi research is hampered. As a result, our understanding of S. Typhi pathogenesis is incomplete, thereby delaying the development and improvement of prevention and treatment strategies. Nonetheless, to better combat and contain S. Typhi, it is vital to develop a vaccine and therapy for controlling both acutely and chronically infected individuals. This review discusses how scientists are trying to combat typhoid fever, why it is so challenging to do so, which approaches show promise, and what we know about the pathogenesis of S. Typhi chronic infection.

scholarly journals Irrational use of azithromycin in typhoid endemic areas: A challenge on multidrug-resistant typhoid treatment

2021 ◽  
Vol 1 (2) ◽  
pp. 37-40
Author(s):  
Irfan Ullah ◽  
Kiran Shafiq Khan ◽  
Qasim Mehmood ◽  
Muhammad Junaid Tahir ◽  
Muhammad Irfan Malik ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Typhoid Fever ◽  
Developed Countries ◽  
Salmonella Typhi ◽  
Multidrug Resistant ◽  
Fatal Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Food Borne ◽  
Marked Decline

Typhoid is a food-borne fatal disease caused by Salmonella typhi. It causes inflammation of the intestine, resulting in diarrhoea, fever, headache, cough, and muscle pain. Improved hygiene has resulted in a marked decline in typhoid fever cases in many developed countries. However, significant typhoid cases emerge in low and middle-income countries annually, including Pakistan. Typhoid fever accounts for a larger percentage of acute febrile illnesses in Pakistan. Azithromycin is the only effective drug used in multidrug-resistant typhoid. The emergence of drug resistance typhoid has been of more significant concern in recent years due to its irrational use of azithromycin. It is considered the last antibiotic to eradicate multidrug-resistant typhoid fever from Pakistan. In this article, we express our concern of the irrational use of azithromycin in Pakistan and its effect on typhoid in the country.

scholarly journals Review on the Recent Advances on Typhoid Vaccine Development and Challenges Ahead

2020 ◽  
Vol 71 (Supplement_2) ◽  
pp. S141-S150
Author(s):  
Khalid Ali Syed ◽  
Tarun Saluja ◽  
Heeyoun Cho ◽  
Amber Hsiao ◽  
Hanif Shaikh ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Low Income ◽  
Vaccine Development ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sanitation And Hygiene ◽  
Contaminated Food ◽  
Improved Sanitation ◽  
Typhoid Vaccines ◽  
And Control

Abstract Control of Salmonella enterica serovar typhi (S. typhi), the agent of typhoid fever, continues to be a challenge in many low- and middle-income countries. The major transmission route of S. typhi is fecal-oral, through contaminated food and water; thus, the ultimate measures for typhoid fever prevention and control include the provision of safe water, improved sanitation, and hygiene. Considering the increasing evidence of the global burden of typhoid, particularly among young children, and the long-term horizon for sustained, effective water and sanitation improvements in low-income settings, a growing consensus is to emphasize preventive vaccination. This review provides an overview of the licensed typhoid vaccines and vaccine candidates under development, and the challenges ahead for introduction.

scholarly journals Metagenome-Wide Analysis of Rural and Urban Surface Waters and Sediments in Bangladesh Identifies Human Waste as a Driver of Antibiotic Resistance

mSystems ◽  
2021 ◽  
Author(s):  
Ross Stuart McInnes ◽  
Md Hassan uz-Zaman ◽  
Imam Taskin Alam ◽  
Siu Fung Stanley Ho ◽  
Robert A. Moran ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Surface Waters ◽  
Antibiotic Resistance Genes ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Middle Income ◽  
Antibiotic Resistant ◽  
Human Waste ◽  
Middle Income Countries ◽  
Rural And Urban

Low- and middle-income countries (LMICs) have higher burdens of multidrug-resistant infections than high-income countries, and there is thus an urgent need to elucidate the drivers of the spread of antibiotic-resistant bacteria in LMICs. Here, we study the diversity and abundance of antibiotic resistance genes in surface water and sediments from rural and urban settings in Bangladesh.

scholarly journals Implementation of Interventions for the Control of Typhoid Fever in Low- and Middle-Income Countries

2018 ◽  
Vol 99 (3_Suppl) ◽  
pp. 79-88 ◽  
Author(s):  
Raluca Barac ◽  
Daina Als ◽  
Amruta Radhakrishnan ◽  
Michelle F. Gaffey ◽  
Zulfiqar A. Bhutta ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Building a Sustainable Comprehensive Multiple Myeloma Program in Western Kenya

2021 ◽  
pp. 400-407
Author(s):  
Mercy A. Oduor ◽  
Teresa C. Lotodo ◽  
Terry A. Vik ◽  
Kelvin M. Manyega ◽  
Patrick Loehrer ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Patient Outcomes ◽  
Support Group ◽  
Healthcare Professionals ◽  
Treatment Strategies ◽  
Middle Income ◽  
Western Kenya ◽  
Middle Income Countries ◽  
Set Up ◽  
Future Plans

Despite improved treatment strategies for multiple myeloma (MM), patient outcomes in low- and middle-income countries remain poor, unlike high-income countries. Scarcity of specialized human resources and diagnostic, treatment, and survivorship infrastructure are some of the barriers that patients with MM, clinicians, and policymakers have to overcome in the former setting. To improve outcomes of patients with MM in Western Kenya, the Academic Model Providing Access to Healthcare (AMPATH) MM Program was set up in 2012. In this article, the program's activities, challenges, and future plans are described distilling important lessons that can be replicated in similar settings. Through the program, training on diagnosis and treatment of MM was offered to healthcare professionals from 35 peripheral health facilities across Western Kenya in 2018 and 2019. Access to antimyeloma drugs including novel agents was secured, and pharmacovigilance systems were developed. Finally, patients were supported to obtain health insurance in addition to receiving peer support through participation in support group meetings. This article provides an implementation blueprint for similar initiatives aimed at increasing access to care for patients with MM in underserved areas.

scholarly journals Middle income trap and factors affecting the risk of growth slowdown in upper middle income countries

2020 ◽  
Vol 9 (4) ◽  
pp. 350-360
Author(s):  
Uğur Ursavaş ◽  
Hakan Sarıbaş
Keyword(s):  
Trade Openness ◽  
The United States ◽  
Institutional Factors ◽  
Law And Order ◽  
Probit Regression ◽  
Middle Income ◽  
Factors Affecting ◽  
Middle Income Countries ◽  
Inflation Variability ◽  
Do So

In this paper, we investigate the macroeconomic, demographic and institutional factors affecting the probability of growth slowdown in upper-middle-income countries within the framework of the growth slowdown methodology developed by Eichengreen et al. (2011). To do so, we use probit regression, and the dataset covers the period 1980-2015. The results show that growth slowdown occurs when per capita income reaches 22 percent of that in the United States. Besides, an increase in the relative income, gross capital formation, trade openness, years of total schooling, old dependency ratio and law and order index increases the risk of growth slowdown, whereas an increase in public debt, inflation variability and years of secondary and higher schooling decreases the risk of growth slowdown.

scholarly journals Economic evaluations of HBV testing and treatment strategies and applicability to low and middle-income countries

2017 ◽  
Vol 17 (S1) ◽  
Author(s):  
Shevanthi Nayagam ◽  
Elisa Sicuri ◽  
Maud Lemoine ◽  
Philippa Easterbrook ◽  
Lesong Conteh ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Economic Evaluations ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals The Mortality Burden of Multidrug-resistant Pathogens in India: A Retrospective, Observational Study

2018 ◽  
Vol 69 (4) ◽  
pp. 563-570 ◽  
Author(s):  
Sumanth Gandra ◽  
Katie K Tseng ◽  
Anita Arora ◽  
Bhaskar Bhowmik ◽  
Matthew L Robinson ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Future Research ◽  
Middle Income ◽  
Health Crisis ◽  
Transmission Mechanisms ◽  
Hospital Study

Abstract Background The threat posed by antibiotic resistance is of increasing concern in low- and middle-income countries (LMICs) as their rates of antibiotic use increase. However, an understanding of the burden of resistance is lacking in LMICs, particularly for multidrug-resistant (MDR) pathogens. Methods We conducted a retrospective, 10-hospital study of the relationship between MDR pathogens and mortality in India. Patient-level antimicrobial susceptibility test (AST) results for Enterococcus spp., Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. were analyzed for their association with patient mortality outcomes. Results We analyzed data on 5103 AST results from 10 hospitals. The overall mortality rate of patients was 13.1% (n = 581), and there was a significant relationship between MDR and mortality. Infections with MDR and extensively drug resistant (XDR) E. coli, XDR K. pneumoniae, and MDR A. baumannii were associated with 2–3 times higher mortality. Mortality due to methicillin-resistant S. aureus (MRSA) was significantly higher than susceptible strains when the MRSA isolate was resistant to aminoglycosides. Conclusions This is one of the largest studies undertaken in an LMIC to measure the burden of antibiotic resistance. We found that MDR bacterial infections pose a significant risk to patients. While consistent with prior studies, the variations in drug resistance and associated mortality outcomes by pathogen are different from those observed in high-income countries and provide a baseline for studies in other LMICs. Future research should aim to elucidate the burden of resistance and the differential transmission mechanisms that drive this public health crisis.

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