Improved lab capacity needed to enhance prevention of typhoid fever in Uganda

A large outbreak of typhoid fever in Uganda was detected due to elevated cases of uncommon intestinal perforations. Therefore, CDC researchers recommend the enhancement of lab capacity for blood cultures in this area to improve prevention and control measures of typhoid fever.

From Dec. 27, 2007, to July 8, 2009, typhoid fever was suspected in 577 patients; intestinal perforation was reported in 249 patients. Researchers then conducted enhanced surveillance in 241 patients between March 4, 2009, and July 30, 2009. After fever and abdominal pain, the most frequently reported symptoms were general body weakness and headache.

Specimens for culture were collected from 102 patients, of which 27 were laboratory confirmed as Salmonella Typhi infection. Nineteen blood cultures were positive, as were 10 stool cultures and six unlabled cultures. Of the 27 laboratory-confirmed S. Typhi isolates, 16 were resistant to ampicillin, streptomycin, sulfisoxazole, tetracycline and cotrimoxazole, but were susceptible to chloramphenicol. There was uniform susceptibility to ciprofloxacin.

“The true burden of typhoid fever in Africa remains unclear,” the researchers wrote. “Lack of laboratory diagnostic capacity in many African countries limits the ability to recognize endemic typhoid fever and detect outbreaks. Additional population-based surveillance studies with laboratory confirmation will yield more precise estimates of the incidence of typhoid fever in Africa.”

References:
  • Neil KP. Clin Infect Dis. 2012;54:1091-1099. 

Disclosure: The researchers report no relevant financial disclosures.

A large outbreak of typhoid fever in Uganda was detected due to elevated cases of uncommon intestinal perforations. Therefore, CDC researchers recommend the enhancement of lab capacity for blood cultures in this area to improve prevention and control measures of typhoid fever.

From Dec. 27, 2007, to July 8, 2009, typhoid fever was suspected in 577 patients; intestinal perforation was reported in 249 patients. Researchers then conducted enhanced surveillance in 241 patients between March 4, 2009, and July 30, 2009. After fever and abdominal pain, the most frequently reported symptoms were general body weakness and headache.

Specimens for culture were collected from 102 patients, of which 27 were laboratory confirmed as Salmonella Typhi infection. Nineteen blood cultures were positive, as were 10 stool cultures and six unlabled cultures. Of the 27 laboratory-confirmed S. Typhi isolates, 16 were resistant to ampicillin, streptomycin, sulfisoxazole, tetracycline and cotrimoxazole, but were susceptible to chloramphenicol. There was uniform susceptibility to ciprofloxacin.

“The true burden of typhoid fever in Africa remains unclear,” the researchers wrote. “Lack of laboratory diagnostic capacity in many African countries limits the ability to recognize endemic typhoid fever and detect outbreaks. Additional population-based surveillance studies with laboratory confirmation will yield more precise estimates of the incidence of typhoid fever in Africa.”

References:
  • Neil KP. Clin Infect Dis. 2012;54:1091-1099. 

Disclosure: The researchers report no relevant financial disclosures.