Incidence of Typhoid Bacteremia in Infants and Young Children in Southern Coastal Pakistan

Document Type



Paediatrics and Child Health


Introduction: The burden of typhoid fever in preschool children is not well recognized. The Purpose of this study was to estimate the incidence of typhoid bacteremia in Pakistani children age, with a focus on children younger than 2 years of age. This will help to inform prevention policies in highly endemic countries. Methods: Household surveillance from February 1, 2007 to May 12, 2008, was carried out by community health workers in 2 low-income, coastal communities of Karachi. Workers referred each sick child consent, and inoculated in BACTEC Peds Plus bottles (Becton Dickinson, Sparks, MD) and processed per manufacturer's guidelines. Results: Overall, 5570 children contributed 3949 observation years. Blood culture was obtained from 1165 cases, yielding 36 pathogens. Salmonella Typhi was isolated in 16 cases, Salmonella Paratyphi A in 2 cases, and Salmonella Paratyphi B in 1 case. The incidence of typhoid bacteremia in children (95% confidence interval, 193.8-876.5) per 100,000 child years. The overall incidence rate of typhoid for children (95% confidence interval, 239.8-643.9) per 100,000 child years. Conclusion: Typhoid is a common and significant cause of morbidity among young children in Pakistan, including children less than 2 years of age. Vaccines that provide protection to preschool children should be included in typhoid control efforts.

Publication (Name of Journal)

Pediatric Infectious Disease Journal