Table 2 The incidence of MDR typhoid fever in sub-Saharan Africaa

From: The phylogeography and incidence of multi-drug resistant typhoid fever in sub-Saharan Africa

Country

Age group in years

PYO estimationb

Recruitment proportionb

Genome-sequenced S. Typhi casesc

Crude MDR S. Typhi cases

Crude MDR S. Typhi incidence per 100,000 PYO

Adjusted MDR S. Typhi cases

Adjusted MDR S. Typhi incidence per 100,000 PYO (95% CI)d

  

Proportion of catchment population visiting study facility in case of fever (95% CI)

Catchment population

Catchment population adjusted by health-seeking behavior

PYO

Ghana e

 AAN

0–1

16% (14–18)

11222

1760

4080

41%

1

1

25

2

60 (17–210)

2–4

16% (13–18)

8086

1268

2940

41%

17

12

306

22

747 (491–1135)

0–4

n.a.

n.a.

n.a.

n.a.

n.a.

18

13

n.a.

n.a.

n.a.

5–14

16% (15–17)

34439

5415

12554

623/1657 (38%)

23

16

96

24

252 (177–357)

<15

n.a.

53747

8443

19574

n.a.

41

29

97

81

414 (333–515)

≥15

n.a.

n.a.

n.a.

n.a.

n.a.

22

16

n.a.

n.a.

n.a.

Non_TSAPe

n.a.

n.a.

n.a.

n.a.

n.a.

38

23

n.a.

n.a.

n.a.

All

n.a.

n.a.

n.a.

n.a

n.a.

101

68

n.a.

n.a.

n.a.

Kenya

 Kibera

0–1

42% (38–47)

3467

1456

2031

99/99 (100%)

5

3

148

3

148 (48–458)

2–4

39% (36–43)

3070

1197

2039

312/312 (100%)

11

7

343

7

343 (164–720)

5–14

43% (39–47)

7514

3231

5722

539/539 (100%)

32

29

507

29

507 (352–729)

<15

n.a.

14051

5884

9792

n.a.

48

39

398

39

398 (291–545)

≥15

35% (32–38)

15263

5342

9228

301/301 (100%)

11

11

119

11

119 (66–215)

All

n.a.

29314

11227

19020

n.a.

59

50

263

50

263 (199–347)

Tanzania f

 

 Moshi Rural

0–1

4% (0–11)

24289

390

693

79%

0

0

0

0

0

2–4

2% (0–4)

25281

406

721

79%

0

0

0

0

0

5–14

13% (10–16)

118219

15487

27508

79%

1 (2)f

0

0

0

0

<15

n.a.

167789

16283

28922

n.a.

1 (2)f

0

0

0

0

≥15

2% (1–2)

298948

5172

9186

79%

2 (4)f

0

0

0

0

All

n.a.

466737

21454

38108

n.a.

3 (6)f

0

0

0

0

 Moshi Urban

0–1

7% (0–19)

10406

335

595

79%

0

0

0

0

0

2–4

2% (0–6)

10831

348

618

79%

0

0

0

0

0

5–14

13% (8–19)

37309

4850

8615

79%

3 (9)f

2 (7)f

12 (81)f

1 (9)f

15 (3–84) (103 (54–199)) f

<15

n.a.

58546

5533

9828

n.a.

3 (9)f

2 (7)f

10 (71)f

1 (9)f

10 (1–72) (91 (47–175)) f

≥15

n.a.

125746

2138

3796

79%

4 (8)f

2 (4)f

53 (105)f

3 (5)f

67 (19–229) (133 (56–319)) f

All

n.a.

184292

7671

13626

n.a.

7 (17)f

4 (11)f

29 (81)f

4 (14)f

29 (11–78) (103 (61–173)) f

  1. aThe TSAP study has data from total 10 countries, of which 9 countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, and Tanzania in alphabetical order) found blood culture confirmed S. Typhi isolates circulating in the respective sites. These S. Typhi isolates have been whole-genome sequenced for detection of multidrug resistant (MDR) genes. In addition, S. Typhi isolates yielded from 2 other surveillance activities in Uganda and The Gambia have been added to this analysis. Of these 11 countries, S. Typhi isolates with MDR genes were detected in Ghana from West Africa and Kenya, Tanzania, and Uganda from East Africa. Incidence of MDR S. Typhi in Uganda could not be estimated due to insufficient data on age stratification of patients, catchment population, healthcare seeking behavior and recruitment proportion, which were applied uniformly for the analysis presented in this table for Ghana, Kenya, and Tanzania
  2. bPYO estimation and recruitment proportion have been published in detail in the TSAP typhoid burden paper (Marks et al, Lancet Global Health, 2017).
  3. cGenome sequenced S. Typhi case numbers in this table may not exactly match the crude S. Typhi case numbers reported in the TSAP typhoid burden paper (Marks et al) due to few sequencing failures
  4. dAdjusted incidence rates per 100,000 PYO (95% CI): adjustments for case recruitment and error factors
  5. eGhana samples include non-TSAP projects as outlined in the Supplementary Table 2. AAN: Asante Akim North (Supplementary Table 2)
  6. fTanzania: Enrolment algorithm has been applied to the crude MDR S. Typhi case numbers, that is: recruitment by every 5th patient if enrolled before Nov 11th 2011 and every 2nd patient if enrolled after then. 1 isolate from Tanzania, which was from outside the study catchment area (Supplementary Table 2: “Moshi Other”) is not included in this incidence table due to the insufficient background data required as mentioned in this footnote
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