In the Journals

Typhoid surveillance, vaccination lacking in endemic areas

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October 6, 2014

Among the 48 countries in the WHO Southeast Asia and Western Pacific regions, only nine reported implementing typhoid vaccination programs and 23 collected surveillance data on typhoid cases from 2009 to 2013, according to a report in MMWR.

In 2008, WHO recommended using typhoid vaccines and strengthening typhoid surveillance in endemic areas. Researchers from WHO and the CDC evaluated data from the WHO/UNICEF Joint Reporting Form on Immunization to evaluate the status of vaccination and surveillance programs in the Southeast Asia and Western Pacific regions within the 5 years after the recommendation.

“Despite the substantial and recognized disease burden, typhoid fever remains a neglected disease in both the Southeast Asia and Western Pacific regions,” the researchers wrote. “Coordinated action involving key stakeholders and partners at the regional and national levels is needed to create appropriate typhoid fever prevention and control policies and strategies, especially in settings with high incidence of disease.”

Twenty-three of the 48 countries in these regions collected data on typhoid cases and, of those, 22 reported that typhoid was a notifiable disease and 20 conducted surveillance activities. Fifteen of the countries reported having a standard definition for typhoid fever, although the definition varied by countries. Nineteen countries reported conducting laboratory testing for suspected typhoid cases.

Nine of the 48 countries implemented a vaccination program or recommended people receive the vaccine. In most countries, the vaccination programs were targeted to high-risk groups and food handlers. Eleven other countries reported vaccine use in the private sector.

“Progress in typhoid disease surveillance and use of typhoid vaccine in Southeast Asia and Western Pacific regions has been limited during the 5 years since revision of the WHO recommendations for typhoid vaccines in 2008,” the investigators wrote.

Disclosure: The researchers report no relevant financial disclosures.

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