Economic and Health System Impacts of Typhoid Control Strategies in Uganda: Vaccination Versus Antibiotic Treatment

Typhoid fever remains a significant public health challenge in Uganda, where inadequate sanitation, urbanization, and limited access to clean water contribute to frequent outbreaks. Antibiotic treatment has long been the mainstay of managing the disease, but rising antibiotic resistance complicates effective treatment, leading to higher healthcare costs and treatment failures. Vaccination, particularly with the typhoid conjugate vaccine (TCV), offers a promising alternative to reduce the disease burden and prevent outbreaks. However, challenges such as vaccine hesitancy, logistical difficulties, and high initial costs hinder large-scale implementation. This review examines the economic and health system impacts of antibiotic treatment versus vaccination strategies for typhoid fever control in Uganda. It explores the limitations of current antibiotic therapies, the potential cost-effectiveness of vaccination programs, and the feasibility of scaling up immunization efforts. The review also discusses how integrated strategies, combining both antibiotics and vaccines, could optimize outcomes and reduce the strain on Uganda’s healthcare system. Recommendations include strengthening vaccination efforts, monitoring antibiotic use, expanding public awareness, enhancing surveillance, and leveraging international partnerships to improve the effectiveness and sustainability of typhoid fever control in Uganda. Keywords: Typhoid fever, Uganda, antibiotic resistance, typhoid conjugate vaccine.