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Figure 1. Cost (2005 US$) of blood culture-confirmed typhoid illness for hospitalized cases in six Asian settings in the Diseases of the Most Impoverished Program. [dagger] Study conducted by All India Institute of Medical Sciences (AIIMS) in 1996 and reanalyzed by the Diseases of the Most Impoverished (DOMI) Program.
(Figure omitted. See article PDF.)
Figure 2. Incidence of typhoid and the use of Vi polysaccharide vaccine in high-endemic regions of Guangxi Zhuang Autonomous Region, China (1995-2007).
(Figure omitted. See article PDF.)
Figure 3. Incidence of typhoid and the use of Vi polysaccharide vaccine in the northwestern region of Vietnam (1997-2007).
(Figure omitted. See article PDF.)
Typhoid fever is a systemic disease caused by the bacterium, Salmonella enterica serovar Typhi (S. Typhi) [1]. S. Typhi is commonly spread through oral transmission of food or water contaminated with the feces of an infected person and is limited to humans. The clinical presentation of typhoid fever ranges from mild fever to severe manifestation, including toxic shock, intestinal hemorrhage and intestinal perforation [1]. For patients presenting with fever, it may be difficult for the clinician to differentiate typhoid fever from other febrile illnesses such as malaria [2]. Misdiagnosis of typhoid fever may lead to prolongation of fever and result in complications such as encephalopathy and disseminated intravascular coagulation, which can consequently lead to death [3]. Overall, 10-15% of typhoid patients develop severe clinical disease [4]. Typhoid fever cases may become an asymptomatic carrier of S. Typhi, having no apparent clinical symptoms but capable of infecting others. Approximately 5% of the typhoid fever patients are assumed to become chronic carriers and they are usually elderly females [5].
Even though typhoid fever has been nearly eradicated in the developed world through major improvements in hygiene and sanitation, the disease continues to be a significant public health problem in the developing world. The nonavailability of clean and safe drinking water, abundance of street vendors selling unhygienic food and high population density in the urban settings increase the risk of contracting typhoid fever in the developing world [6-8]. While hygiene and sanitation are critical measures to prevent typhoid fever, these are long-term solutions that require financial investment, political will and behavioral change, which are difficult goals to attain for a developing...