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Epidemiology clinical presentation and patterns of drug resistance of Salmonella Typhi in Karachi Pakistan

Khan, M. Imran, Soofi, Sajid Bashir, Ochiai, R. Leon, Khan, Mohammad Jawed, Sahito, Shah Muhammad, Habib, Muhammad Atif, Puri, Mahesh K., von Seidlein, Lorenz, Park, Jin Kyung, You, Young Ae, Ali, Mohammad, Nizami, Qamaruddin S., Acosta, Camillo J., Sack, R. Bradley, Clemens, John D. and Bhutta, Zulfiqar A. (2012). Epidemiology clinical presentation and patterns of drug resistance of Salmonella Typhi in Karachi Pakistan. Journal of infection in developing countries,6(10):704-714.

Document type: Journal Article
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IRMA ID bsmithxPUB137
Title Epidemiology clinical presentation and patterns of drug resistance of Salmonella Typhi in Karachi Pakistan
Author Khan, M. Imran
Soofi, Sajid Bashir
Ochiai, R. Leon
Khan, Mohammad Jawed
Sahito, Shah Muhammad
Habib, Muhammad Atif
Puri, Mahesh K.
von Seidlein, Lorenz
Park, Jin Kyung
You, Young Ae
Ali, Mohammad
Nizami, Qamaruddin S.
Acosta, Camillo J.
Sack, R. Bradley
Clemens, John D.
Bhutta, Zulfiqar A.
Journal Name Journal of infection in developing countries
Publication Date 2012
Volume Number 6
Issue Number 10
ISSN 1972-2680   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84868014323
Start Page 704
End Page 714
Total Pages 11
Place of Publication Italy
Publisher Open Learning on Enteric Pathogens (O L O E P)
HERDC Category C1 - Journal Article (DIISR)
Abstract Introduction:
Enteric fever remains a major public health problem in Asia. Planning appropriate preventive measures such as immunization requires a clear understanding of disease burden. We conducted a community-based surveillance for Salmonella Typhi infection in children in Karachi, Pakistan.

Methodology:
A de jure household census was conducted at baseline in the study setting to enumerate all individuals. A health-care facility-based passive surveillance system was used to capture episodes of fever lasting three or more 3 days in children 2 to 16 years old.

Results:
A total of 7,401 blood samples were collected for microbiological confirmation, out of which 189 S. Typhi and 32 S. Paratyphi A isolates were identified with estimated annual incidences of 451/100,000 (95% CI: 446 – 457) and 76/100,000 (95% CI: 74 – 78) respectively. At the time of presentation, after adjusting for age, there was an association between the duration of fever and temperature at presentation, and being infected with multidrug-resistant S. Typhi. Of 189 isolates 83 were found to be resistant to first-line antimicrobial therapy. There was no statistically significant difference in clinical presentation of blood culture sensitive and resistant S. Typhi isolates.

Conclusion:
Incidence of S. Typhi in children is high in urban squatter settlements of Karachi, Pakistan. Findings from this study identified duration of fever and temperature at the time of presentation as important symptoms associated with blood culture-confirmed typhoid fever. Preventive strategies such as immunization and improvements in water and sanitation conditions should be the focus of typhoid control in urban settlements of Pakistan.
Keywords S. Typhi
Population-based incidence
Drug resistance
Pakistan
Open access True
Additional Notes This work is licensed under a Creative Commons Attribution 3.0 License http://creativecommons.org/licenses/by/3.0/
Description for Link Link to published version
URL http://www.jidc.org/index.php/journal/article/view/23103892


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