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dc.contributor.authorSikorski, Michael J
dc.contributor.authorDesai, Sachin N
dc.contributor.authorTupua, Siaosi
dc.contributor.authorThomsen, Robert E
dc.contributor.authorHan, Jane
dc.contributor.authorRambocus, Savitra
dc.contributor.authorNimarota-Brown, Susana
dc.contributor.authorPunimata, Linatupu
dc.contributor.authorTusitala, Salesa
dc.contributor.authorSialeipata, Michelle
dc.contributor.authorHoffman, Seth A
dc.contributor.authorTracy, J Kathleen
dc.contributor.authorHigginson, Ellen E
dc.contributor.authorTennant, Sharon M
dc.contributor.authorGauld, Jillian S
dc.contributor.authorKlein, Daniel J
dc.contributor.authorBallard, Susan A
dc.contributor.authorRobins-Browne, Roy M
dc.contributor.authorDougan, Gordon
dc.contributor.authorNilles, Eric J
dc.contributor.authorHowden, Benjamin P
dc.contributor.authorCrump, John A
dc.contributor.authorNaseri, Take K
dc.contributor.authorLevine, Myron M
dc.date.accessioned2020-08-13T13:57:47Z
dc.date.available2020-08-13T13:57:47Z
dc.date.issued2020-07-29
dc.identifier.urihttp://hdl.handle.net/10713/13538
dc.description.abstractBACKGROUND: Typhoid fever has been endemic on the island nation of Samoa (2016 population, 195 979) since the 1960s and has persisted through 2019, despite economic development and improvements in water supply and sanitation. METHODS: Salmonella enterica serovar Typhi isolates from the 2 hospitals with blood culture capability and matched patient demographic and clinical data from January 2008 through December 2019 were analyzed. Denominators to calculate incidence by island, region, and district came from 2011 and 2016 censuses and from 2017-2019 projections from Samoa's Bureau of Statistics. Data were analyzed to describe typhoid case burden and incidence from 2008 to 2019 by time, place, and person. RESULTS: In sum, 53-193 blood culture-confirmed typhoid cases occurred annually from 2008 to 2019, without apparent seasonality. Typhoid incidence was low among children age < 48 months (17.6-27.8/105), rose progressively in ages 5-9 years (54.0/105), 10-19 years (60.7-63.4/105), and 20-34 years (61.0-79.3/105), and then tapered off; 93.6% of cases occurred among Samoans < 50 years of age. Most typhoid cases and the highest incidence occurred in Northwest Upolu, but Apia Urban Area (served by treated water supplies) also exhibited moderate incidence. The proportion of cases from short-cycle versus long-cycle transmission is unknown. Samoan S. Typhi are pansusceptible to traditional first-line antibiotics. Nevertheless, enhanced surveillance in 2019 detected 4 (2.9%) deaths among 140 cases. CONCLUSIONS: Typhoid has been endemic in Samoa in the period 2008-2019. Interventions, including mass vaccination with a Vi-conjugate vaccine coadministered with measles vaccine are planned. © The Author(s) 2020.en_US
dc.description.urihttps://doi.org/10.1093/cid/ciaa314en_US
dc.language.isoen_USen_US
dc.publisherOxford University Pressen_US
dc.relation.ispartofClinical Infectious Diseasesen_US
dc.subjectSalmonella Typhien_US
dc.subjectOceaniaen_US
dc.subjectSamoaen_US
dc.subjectepidemiologyen_US
dc.subjecttyphoid feveren_US
dc.titleTenacious Endemic Typhoid Fever in Samoaen_US
dc.typeArticleen_US
dc.identifier.doi10.1093/cid/ciaa314
dc.identifier.pmid32725232
dc.source.volume71
dc.source.issueSupplement_2
dc.source.beginpageS120
dc.source.endpageS126
dc.source.countryUnited States


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