The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017

GBD 2017 Typhoid and Paratyphoid Collaborators, Jeffrey D. Stanaway, Robert C. Reiner, Brigette F. Blacker, Ellen M. Goldberg, Ibrahim A. Khalil, Christopher E. Troeger, Jason R. Andrews, Zulfiqar A. Bhutta, John A. Crump, Justin Im, Florian Marks, Eric Mintz, Se Eun Park, Anita K.M. Zaidi, Zegeye Abebe, Ayenew Negesse Abejie, Isaac Akinkunmi Adedeji, Beriwan Abdulqadir Ali, Hagos Tasew Atalay & 30 others Azmeraw Amare, Umar Bacha, Aleksandra Barac, Neeraj Bedi, Adugnaw Berhane, Annie J. Browne, Jesus L. Chirinos, Abdulaal Chitheer, Christiane Dolecek, Maysaa El Sayed Zaki, Babak Eshrati, Kyle J. Foreman, Abdella Gemechu, Rahul Gupta, Gessessew Bugssa Hailu, Andualem Henok, Desalegn Tsegaw Hibstu, Chi Linh Hoang, Olayinka Stephen Ilesanmi, Veena J. Iyer, Amaha Kahsay, Amir Kasaeian, Tesfaye Dessale Kassa, Ejaz Ahmad Khan, Young Ho Khang, Hassan Magdy Abd El Razek, Mulugeta Melku, Desalegn Tadese Mengistu, Karzan Abdulmuhsin Mohammad, Shafiu Mohammed

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Efforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, and the approach taken to produce them. Methods: For this systematic analysis we broke down the relative contributions of typhoid and paratyphoid fevers by country, year, and age, and analysed trends in incidence and mortality. We modelled the combined incidence of typhoid and paratyphoid fevers and split these total cases proportionally between typhoid and paratyphoid fevers using aetiological proportion models. We estimated deaths using vital registration data for countries with sufficiently high data completeness and using a natural history approach for other locations. We also estimated disability-adjusted life-years (DALYs) for typhoid and paratyphoid fevers. Findings: Globally, 14·3 million (95% uncertainty interval [UI] 12·5–16·3) cases of typhoid and paratyphoid fevers occurred in 2017, a 44·6% (42·2–47·0) decline from 25·9 million (22·0–29·9) in 1990. Age-standardised incidence rates declined by 54·9% (53·4–56·5), from 439·2 (376·7–507·7) per 100 000 person-years in 1990, to 197·8 (172·0–226·2) per 100 000 person-years in 2017. In 2017, Salmonella enterica serotype Typhi caused 76·3% (71·8–80·5) of cases of enteric fever. We estimated a global case fatality of 0·95% (0·54–1·53) in 2017, with higher case fatality estimates among children and older adults, and among those living in lower-income countries. We therefore estimated 135·9 thousand (76·9–218·9) deaths from typhoid and paratyphoid fever globally in 2017, a 41·0% (33·6–48·3) decline from 230·5 thousand (131·2–372·6) in 1990. Overall, typhoid and paratyphoid fevers were responsible for 9·8 million (5·6–15·8) DALYs in 2017, down 43·0% (35·5–50·6) from 17·2 million (9·9–27·8) DALYs in 1990. Interpretation: Despite notable progress, typhoid and paratyphoid fevers remain major causes of disability and death, with billions of people likely to be exposed to the pathogens. Although improvements in water and sanitation remain essential, increased vaccine use (including with typhoid conjugate vaccines that are effective in infants and young children and protective for longer periods) and improved data and surveillance to inform vaccine rollout are likely to drive the greatest improvements in the global burden of the disease. Funding: Bill & Melinda Gates Foundation.

LanguageEnglish
Pages369-381
Number of pages13
JournalThe Lancet Infectious Diseases
Volume19
Issue number4
DOIs
Publication statusPublished - 1 Apr 2019

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

@article{8273cdb249014fe8aa993d15bdad09da,
title = "The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017",
abstract = "Background: Efforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, and the approach taken to produce them. Methods: For this systematic analysis we broke down the relative contributions of typhoid and paratyphoid fevers by country, year, and age, and analysed trends in incidence and mortality. We modelled the combined incidence of typhoid and paratyphoid fevers and split these total cases proportionally between typhoid and paratyphoid fevers using aetiological proportion models. We estimated deaths using vital registration data for countries with sufficiently high data completeness and using a natural history approach for other locations. We also estimated disability-adjusted life-years (DALYs) for typhoid and paratyphoid fevers. Findings: Globally, 14·3 million (95{\%} uncertainty interval [UI] 12·5–16·3) cases of typhoid and paratyphoid fevers occurred in 2017, a 44·6{\%} (42·2–47·0) decline from 25·9 million (22·0–29·9) in 1990. Age-standardised incidence rates declined by 54·9{\%} (53·4–56·5), from 439·2 (376·7–507·7) per 100 000 person-years in 1990, to 197·8 (172·0–226·2) per 100 000 person-years in 2017. In 2017, Salmonella enterica serotype Typhi caused 76·3{\%} (71·8–80·5) of cases of enteric fever. We estimated a global case fatality of 0·95{\%} (0·54–1·53) in 2017, with higher case fatality estimates among children and older adults, and among those living in lower-income countries. We therefore estimated 135·9 thousand (76·9–218·9) deaths from typhoid and paratyphoid fever globally in 2017, a 41·0{\%} (33·6–48·3) decline from 230·5 thousand (131·2–372·6) in 1990. Overall, typhoid and paratyphoid fevers were responsible for 9·8 million (5·6–15·8) DALYs in 2017, down 43·0{\%} (35·5–50·6) from 17·2 million (9·9–27·8) DALYs in 1990. Interpretation: Despite notable progress, typhoid and paratyphoid fevers remain major causes of disability and death, with billions of people likely to be exposed to the pathogens. Although improvements in water and sanitation remain essential, increased vaccine use (including with typhoid conjugate vaccines that are effective in infants and young children and protective for longer periods) and improved data and surveillance to inform vaccine rollout are likely to drive the greatest improvements in the global burden of the disease. Funding: Bill & Melinda Gates Foundation.",
author = "{GBD 2017 Typhoid and Paratyphoid Collaborators} and Stanaway, {Jeffrey D.} and Reiner, {Robert C.} and Blacker, {Brigette F.} and Goldberg, {Ellen M.} and Khalil, {Ibrahim A.} and Troeger, {Christopher E.} and Andrews, {Jason R.} and Bhutta, {Zulfiqar A.} and Crump, {John A.} and Justin Im and Florian Marks and Eric Mintz and Park, {Se Eun} and Zaidi, {Anita K.M.} and Zegeye Abebe and Abejie, {Ayenew Negesse} and Adedeji, {Isaac Akinkunmi} and Ali, {Beriwan Abdulqadir} and Atalay, {Hagos Tasew} and Azmeraw Amare and Umar Bacha and Aleksandra Barac and Neeraj Bedi and Adugnaw Berhane and Browne, {Annie J.} and Chirinos, {Jesus L.} and Abdulaal Chitheer and Christiane Dolecek and {El Sayed Zaki}, Maysaa and Babak Eshrati and Foreman, {Kyle J.} and Abdella Gemechu and Rahul Gupta and Hailu, {Gessessew Bugssa} and Andualem Henok and Hibstu, {Desalegn Tsegaw} and Hoang, {Chi Linh} and Ilesanmi, {Olayinka Stephen} and Iyer, {Veena J.} and Amaha Kahsay and Amir Kasaeian and Kassa, {Tesfaye Dessale} and Khan, {Ejaz Ahmad} and Khang, {Young Ho} and {Magdy Abd El Razek}, Hassan and Mulugeta Melku and Mengistu, {Desalegn Tadese} and Mohammad, {Karzan Abdulmuhsin} and Shafiu Mohammed",
year = "2019",
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doi = "10.1016/S1473-3099(18)30685-6",
language = "English",
volume = "19",
pages = "369--381",
journal = "The Lancet Infectious Diseases",
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The global burden of typhoid and paratyphoid fevers : a systematic analysis for the Global Burden of Disease Study 2017. / GBD 2017 Typhoid and Paratyphoid Collaborators.

In: The Lancet Infectious Diseases, Vol. 19, No. 4, 01.04.2019, p. 369-381.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The global burden of typhoid and paratyphoid fevers

T2 - The Lancet Infectious Diseases

AU - GBD 2017 Typhoid and Paratyphoid Collaborators

AU - Stanaway, Jeffrey D.

AU - Reiner, Robert C.

AU - Blacker, Brigette F.

AU - Goldberg, Ellen M.

AU - Khalil, Ibrahim A.

AU - Troeger, Christopher E.

AU - Andrews, Jason R.

AU - Bhutta, Zulfiqar A.

AU - Crump, John A.

AU - Im, Justin

AU - Marks, Florian

AU - Mintz, Eric

AU - Park, Se Eun

AU - Zaidi, Anita K.M.

AU - Abebe, Zegeye

AU - Abejie, Ayenew Negesse

AU - Adedeji, Isaac Akinkunmi

AU - Ali, Beriwan Abdulqadir

AU - Atalay, Hagos Tasew

AU - Amare, Azmeraw

AU - Bacha, Umar

AU - Barac, Aleksandra

AU - Bedi, Neeraj

AU - Berhane, Adugnaw

AU - Browne, Annie J.

AU - Chirinos, Jesus L.

AU - Chitheer, Abdulaal

AU - Dolecek, Christiane

AU - El Sayed Zaki, Maysaa

AU - Eshrati, Babak

AU - Foreman, Kyle J.

AU - Gemechu, Abdella

AU - Gupta, Rahul

AU - Hailu, Gessessew Bugssa

AU - Henok, Andualem

AU - Hibstu, Desalegn Tsegaw

AU - Hoang, Chi Linh

AU - Ilesanmi, Olayinka Stephen

AU - Iyer, Veena J.

AU - Kahsay, Amaha

AU - Kasaeian, Amir

AU - Kassa, Tesfaye Dessale

AU - Khan, Ejaz Ahmad

AU - Khang, Young Ho

AU - Magdy Abd El Razek, Hassan

AU - Melku, Mulugeta

AU - Mengistu, Desalegn Tadese

AU - Mohammad, Karzan Abdulmuhsin

AU - Mohammed, Shafiu

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Background: Efforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, and the approach taken to produce them. Methods: For this systematic analysis we broke down the relative contributions of typhoid and paratyphoid fevers by country, year, and age, and analysed trends in incidence and mortality. We modelled the combined incidence of typhoid and paratyphoid fevers and split these total cases proportionally between typhoid and paratyphoid fevers using aetiological proportion models. We estimated deaths using vital registration data for countries with sufficiently high data completeness and using a natural history approach for other locations. We also estimated disability-adjusted life-years (DALYs) for typhoid and paratyphoid fevers. Findings: Globally, 14·3 million (95% uncertainty interval [UI] 12·5–16·3) cases of typhoid and paratyphoid fevers occurred in 2017, a 44·6% (42·2–47·0) decline from 25·9 million (22·0–29·9) in 1990. Age-standardised incidence rates declined by 54·9% (53·4–56·5), from 439·2 (376·7–507·7) per 100 000 person-years in 1990, to 197·8 (172·0–226·2) per 100 000 person-years in 2017. In 2017, Salmonella enterica serotype Typhi caused 76·3% (71·8–80·5) of cases of enteric fever. We estimated a global case fatality of 0·95% (0·54–1·53) in 2017, with higher case fatality estimates among children and older adults, and among those living in lower-income countries. We therefore estimated 135·9 thousand (76·9–218·9) deaths from typhoid and paratyphoid fever globally in 2017, a 41·0% (33·6–48·3) decline from 230·5 thousand (131·2–372·6) in 1990. Overall, typhoid and paratyphoid fevers were responsible for 9·8 million (5·6–15·8) DALYs in 2017, down 43·0% (35·5–50·6) from 17·2 million (9·9–27·8) DALYs in 1990. Interpretation: Despite notable progress, typhoid and paratyphoid fevers remain major causes of disability and death, with billions of people likely to be exposed to the pathogens. Although improvements in water and sanitation remain essential, increased vaccine use (including with typhoid conjugate vaccines that are effective in infants and young children and protective for longer periods) and improved data and surveillance to inform vaccine rollout are likely to drive the greatest improvements in the global burden of the disease. Funding: Bill & Melinda Gates Foundation.

AB - Background: Efforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, and the approach taken to produce them. Methods: For this systematic analysis we broke down the relative contributions of typhoid and paratyphoid fevers by country, year, and age, and analysed trends in incidence and mortality. We modelled the combined incidence of typhoid and paratyphoid fevers and split these total cases proportionally between typhoid and paratyphoid fevers using aetiological proportion models. We estimated deaths using vital registration data for countries with sufficiently high data completeness and using a natural history approach for other locations. We also estimated disability-adjusted life-years (DALYs) for typhoid and paratyphoid fevers. Findings: Globally, 14·3 million (95% uncertainty interval [UI] 12·5–16·3) cases of typhoid and paratyphoid fevers occurred in 2017, a 44·6% (42·2–47·0) decline from 25·9 million (22·0–29·9) in 1990. Age-standardised incidence rates declined by 54·9% (53·4–56·5), from 439·2 (376·7–507·7) per 100 000 person-years in 1990, to 197·8 (172·0–226·2) per 100 000 person-years in 2017. In 2017, Salmonella enterica serotype Typhi caused 76·3% (71·8–80·5) of cases of enteric fever. We estimated a global case fatality of 0·95% (0·54–1·53) in 2017, with higher case fatality estimates among children and older adults, and among those living in lower-income countries. We therefore estimated 135·9 thousand (76·9–218·9) deaths from typhoid and paratyphoid fever globally in 2017, a 41·0% (33·6–48·3) decline from 230·5 thousand (131·2–372·6) in 1990. Overall, typhoid and paratyphoid fevers were responsible for 9·8 million (5·6–15·8) DALYs in 2017, down 43·0% (35·5–50·6) from 17·2 million (9·9–27·8) DALYs in 1990. Interpretation: Despite notable progress, typhoid and paratyphoid fevers remain major causes of disability and death, with billions of people likely to be exposed to the pathogens. Although improvements in water and sanitation remain essential, increased vaccine use (including with typhoid conjugate vaccines that are effective in infants and young children and protective for longer periods) and improved data and surveillance to inform vaccine rollout are likely to drive the greatest improvements in the global burden of the disease. Funding: Bill & Melinda Gates Foundation.

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U2 - 10.1016/S1473-3099(18)30685-6

DO - 10.1016/S1473-3099(18)30685-6

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VL - 19

SP - 369

EP - 381

JO - The Lancet Infectious Diseases

JF - The Lancet Infectious Diseases

SN - 1473-3099

IS - 4

ER -