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Clinical surveillance of febrile patients and incidence of Salmonella Typhi in Ouagadougou, Burkina Faso

 Nchia, Christian Ngha Kah 
 Graduate School of Public Health (보건대학원) 
 Global heath security detection program 
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Typhoid fever (TF) is an acute gastrointestinal infection caused by the bacterium Salmonella enterica serotype Typhi (S. Typhi), which is transmitted through contaminated food or drinking water from one person to another. Salmonella bacteria is one of the leading causes of community-acquired bloodstream infection which record a high mortality rate in sub Saharan Africa. High incidence of TF is particularly observed in low income countries in sub-Saharan Africa. The objective of this study is to estimate the incidence of TF in Ouagadougou Burkina Faso. Two regions within the capital city Ouagadougou, Nioko and Polesgo, were selected to carry out a population-based prospective febrile surveillance which took place between 2015 and 2016. Participants residing in these two areas and who presented with acute fever 38C, using tympanic temperature records were enrolled into the study. Participants with a history of fever more than 72 hours and <38C and those leaving out of catchment area were excluded from the study. Blood samples were collected from participants and a blood culture was conducted to confirm bacteremia. The results of 1,306 blood culture conducted confirmed 21 samples positive for Salmonella bacteria between 16 June 2015 and 25 April 2016 of which 9 were S. Typhi infections. Two cases were found in children less than 5 years old three cases in the group between 6-15 years. The incidence of S. Typhi overall was calculated to be 125 per 100,000 person years of observation (PYO) with highest prevalence seen in children <5 years. The prevalence of Multi- drug resistant (MDR) S. Typhi isolates, defined as resistance to three or more classes of antibiotics, was high (7/9). Administration of an effective typhoid fever vaccine in children under 5 years of age may be an effective strategy to reduce the burden of TF in Burkina Faso. Further studies characterizing the severity of S. Typhi infections, including the development of intestinal perforation and mortality and including rural areas are necessary.
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