Comparative Epidemiology of <i>Salmonella</i> Paratyphi A and <i>Salmonella</i> Typhi Causing Enteric Fever, Bangladesh, 2018–2020
Enteric fever remains a public health challenge. We analyzed data from a cluster-randomized Vi-tetanus toxoid conjugate vaccine trial to compare the epidemiology between Salmonella enterica serovars Paratyphi A, which causes paratyphoid fever, and Typhi, which causes typhoid fever. The overall incidence rate of paratyphoid fever was 27 (95% CI 23-32)/100,000 person-years (PY) and of typhoid fever was 216 (95% CI 198-236)/100,000 PY. We observed the highest incidence for both diseases in children 2-4 years of age: 72 (95% CI 41-117)/100,000 PY for paratyphoid and 887 (95% CI 715-1,088)/100,000 PY for typhoid. Lack of private toilets and safe drinking water were associated with both diseases. Prevalence of multidrug resistance was significantly higher in Salmonella Typhi (20.2%) than in Salmonella Paratyphi A (0.8%) (p<0.001). Our data suggest that integrated control measures targeting water, sanitation, and hygiene measures and bivalent vaccine targeting both pathogens are promising strategies to control both diseases.
Authors
- Ashraful Islam Khan (ORCID: https://orcid.org/0000-0003-3751-1974)
- Cecilia Mbae (ORCID: https://orcid.org/0000-0002-6933-248X)
- Suneth Agampodi (ORCID: https://orcid.org/0000-0001-7810-1774)
- Martin Bundi (ORCID: https://orcid.org/0000-0001-9932-2453)
- Faisal Ahmmed (ORCID: https://orcid.org/0000-0003-1604-0384)
- Kassa Haile
- Suman Kanungo (ORCID: https://orcid.org/0000-0003-4441-4443)
- Sadia Rahman (ORCID: https://orcid.org/0000-0002-7983-087X)
- Fahima Chowdhury (ORCID: https://orcid.org/0000-0002-6688-1395)
- Afroza Akter (ORCID: https://orcid.org/0000-0001-8374-8556)
- Deok Ryun Kim (ORCID: https://orcid.org/0009-0007-3085-6773)
- Samuel Kariuki (ORCID: https://orcid.org/0000-0003-3209-9503)
- Xinxue Liu (ORCID: https://orcid.org/0000-0003-1107-0365)
- Asma Binte Aziz (ORCID: https://orcid.org/0000-0003-0203-5744)
- Beatrice Ongadi (ORCID: https://orcid.org/0000-0001-6687-6927)
- Md Taufiqul Islam (ORCID: https://orcid.org/0000-0003-1584-484X)
- Kelvin Kering (ORCID: https://orcid.org/0000-0001-6399-7774)
- Andrew J. Pollard (ORCID: https://orcid.org/0000-0001-7361-719X)
- Benjamin Ngugi (ORCID: https://orcid.org/0000-0003-4773-9294)
- Moses Mwangi (ORCID: https://orcid.org/0000-0001-6172-2507)
- Khalequ Zaman (ORCID: https://orcid.org/0000-0002-1982-6879)
- Md Golam Firoj (ORCID: https://orcid.org/0009-0005-1634-5729)
- Justin Im (ORCID: https://orcid.org/0000-0002-3762-084X)
- John D. Clemens (ORCID: https://orcid.org/0000-0002-3002-4279)
- Natasha Y. Rickett (ORCID: https://orcid.org/0000-0002-3172-1877)
- Se Eun Park (ORCID: https://orcid.org/0000-0002-1632-3045)
- Meseret Gebre Behute
- Edilawit Mesfin
Publication Details
- Journal
- Emerging infectious diseases
- Published
- 2025-09-30
- DOI
- https://doi.org/10.3201/eid3110.241601
- Citations
- 1
- Primary Topic
- Salmonella and Campylobacter epidemiology
- Type
- article
- Field-Weighted Citation Impact
- 1.16
Funders
- Bill and Melinda Gates Foundation