Jai K Das|Rumina Hasan|Afia Zafar|Imran Ahmed|Aamer Ikram|Summiya Nizamuddin|Saleel Fatima|Nauman Akbar|Faisal Sultan|Zulfiqar A. Bhutta
Trends, Associations, and Antimicrobial Resistance of Salmonella Typhi and Paratyphi in Pakistan
Aga Khan University|Aga Khan University|Aga Khan University|Aga Khan University|Armed Forces Institute of Pathology|National University of Medical Sciences|Shaukat Khanum Memorial Cancer Hospital and Research Center|Aga Khan University|National University of Medical Sciences|Armed Forces Institute of Pathology|Shaukat Khanum Memorial Cancer Hospital and Research Center|Hospital for Sick Children|SickKids Foundation|Aga Khan University
typhoid remains major cause morbidity mortality endemic countries review analyzed typhoid burden changes pakistan association contextual factors retrospective cohort study blood culturepositive typhoid antibiotic resistance conducted three tertiary hospitals contextual factor data obtained primary household surveys salmonella typhiparatyphi positivity rates estimated trend analysis carried using positive cases total number blood cultures performed contextual factors associations determined bivariate correlation analysis using stata satacorp college station tx report total 17387 typhipositive 8286 paratyphi bpositive specimens 798137 blood cultures performed results suggest overall decline typhoid incidence typhi positivity rates declined 642 1992 132 2015 paratyphi b 129 039 subgroup analysis suggests higher typhi prevalence adults older 18 years whereas paratyphi greater children aged 518 years relative contribution paratyphi overall confirmed cases increased 168 1992 23 2015 analysis suggests high burden fluoroquinolone resistance multidrugresistant typhi strains statistically significant associations water sanitation indicators literacy rates observed typhoid positivity despite progress typhoid remains endemic strong political required targeted typhoid control strategies multipronged approach improving water sanitation hygiene combination largescale immunization endemic settings pakistan could help reduce burden prevent epidemics