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Centre for Global Child Health

Tackling Typhoid – What Do Global & Country Trends Teach Us?

Principal Investigator: Dr. Zulfiqar A. Bhutta, Inaugural Robert Harding Chair in Global Child Health at the Hospital for Sick Children (SickKids), Toronto, Co-Director of the SickKids Centre for Global Child Health and the Founding Director of the Centre of Excellence in Women and Child Health at the Aga Khan University.

Typhoid and paratyphoid fever continue to be significant causes of morbidity and mortality worldwide with the highest burden being reported in low and middle income countries. The heterogeneity present in water, sanitation and hygiene (WASH) infrastructure and practices, socioeconomic determinants, diagnostic test methods and therapeutic procedures both within and between countries highlights the fact that typhoid and paratyphoid fever cannot be eliminated by a single solution in every setting.

Team photo at advisory group meeting
Team members at the Tackling Typhoid (T2) advisory group meeting in London, England

The Tackling Typhoid (T2) project was undertaken in an effort to consolidate the current body of literature on enteric fever and describe longitudinal regional trends in incidence, mortality, severe complications and antimicrobial resistance (AMR) both globally. The second part of this project consists of detailed studies of enteric fever and AMR trends over time in eight endemic countries in conjunction with changes in relevant contextual factors. The eight countries included are Chile, Nigeria, South Africa, Pakistan, India, Bangladesh, Thailand and Vietnam. The main contextual factors, deemed to influence enteric fever transmission a priori, were improved sanitation, improved water, female literacy, poverty rate and diarrheal mortality. Qualitative interviews were also conducted as part of the country case studies to identify interventions and control measures the have been put in place to reduce the burden of typhoid in endemic settings. This project aims to characterize the global and regional burden of typhoid and paratyphoid fever and make recommendations regarding which interventions and policy changes can best help curb the spread of this disease.

Project collaborators include Aga Khan University and Child and Youth Mental Health Research Unit at The Hospital for Sick Children (SickKids).

Supported by: The Bill & Melinda Gates Foundation.