Typhoid Fever remains a major cause of morbidity and mortality in low-income settings. The Severe Typhoid in Africa programme was designed to address regional gaps in typhoid burden data and identify populations eligible for interventions using novel typhoid conjugate vaccines. A hybrid design, hospital-based prospective surveillance with population-based health-care utilisation surveys, was implemented in six countries in sub-Saharan Africa. Patients presenting with fever (≥37·5°C axillary or ≥38·0°C tympanic) or reporting fever for three consecutive days within the previous 7 days were invited to participate. Typhoid fever was ascertained by culture of blood collected upon enrolment. Disease incidence at the population level was estimated using a Bayesian mixture model. 27 866 (33·8%) of 82 491 participants who met inclusion criteria were recruited. Blood cultures were performed for 27 544 (98·8%) of enrolled participants. Clinically significant organisms were detected in 2136 (7·7%) of these cultures, and 346 (16·2%) serovar Typhi were isolated. The overall adjusted incidence per 100 000 person-years of observation was highest in Kavuaya and Nkandu 1, Democratic Republic of the Congo (315, 95% credible interval 254–390). Overall, 46 (16·4%) of 280 tested isolates showed ciprofloxacin non-susceptibility. High disease incidence (ie, >100 per 100 000 person-years of observation) recorded in four countries, the prevalence of typhoid hospitalisations and complicated disease, and the threat of resistant typhoid strains strengthen the need for rapid dispatch and implementation of effective typhoid conjugate vaccines along with measures designed to improve clean water, sanitation, and hygiene practices. The Bill & Melinda Gates Foundation.

中文翻译：

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布基纳法索、刚果民主共和国、埃塞俄比亚、加纳、马达加斯加和尼日利亚的伤寒发病率（非洲严重伤寒计划）：一项基于人群的研究

伤寒仍然是低收入地区发病和死亡的主要原因。非洲严重伤寒计划旨在解决伤寒负担数据的区域差距，并确定适合使用新型伤寒结合疫苗进行干预的人群。撒哈拉以南非洲的六个国家实施了混合设计，即以医院为基础的前瞻性监测和以人口为基础的医疗保健利用率调查。邀请出现发热（腋窝≥37·5°C或鼓室≥38·0°C）或在过去7天内连续三天报告发烧的患者参加。通过入组时收集的血液培养来确定伤寒。使用贝叶斯混合模型估计人口水平的疾病发病率。 82 491 名符合纳入标准的参与者中，招募了 27 866 名（33·8%）。对 27 544 名 (98·8%) 的登记参与者进行了血培养。在 2136 个（7·7%）培养物中检测到具有临床意义的微生物，并分离出 346 个（16·2%）伤寒血清型。刚果民主共和国 Kavuaya 和 Nkandu 1 的每 10 万人年观察的总体调整发病率最高（315，95% 可信区间 254-390）。总体而言，280 个测试分离株中有 46 个 (16·4%) 对环丙沙星不敏感。四个国家记录的高发病率（即每 10 万人年观察中 >100 例）、伤寒住院和复杂疾病的流行以及抗性伤寒菌株的威胁，加强了快速调度和实施有效伤寒结合物的必要性疫苗以及旨在改善清洁水、环境卫生和个人卫生习惯的措施。比尔及梅琳达·盖茨基金会。