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Clin Infect Dis. 2016 Mar 15;62 Suppl 1:S9-S16. doi: 10.1093/cid/civ693.

The Typhoid Fever Surveillance in Africa Program (TSAP): Clinical, Diagnostic, and Epidemiological Methodologies.

Author information

1
International Vaccine Institute, Seoul, Republic of Korea.
2
Bandim Health Project, Bissau, Guinea-Bissau.
3
Kumasi Centre for Collaborative Research in Tropical Medicine School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
4
International Vaccine Institute, Seoul, Republic of Korea Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
5
Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
6
Oxford University Clinical Resarch Unit, Ho Chi Minh City, Vietnam.
7
Centers for Disease Control and Prevention, Nairobi, Kenya Global Health Institute, Emory University, Atlanta, Georgia.
8
Bandim Health Project, Bissau, Guinea-Bissau Research Center for Vitamins and Vaccines, Copenhagen, Denmark.
9
International Vaccine Institute, Seoul, Republic of Korea International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.
10
Division of Infectious Diseases and International Health, Duke University Medical Center Duke Global Health Institute, Duke University, Durham, North Carolina Kilimanjaro Christian Medical Centre, Moshi, Tanzania Centre for International Health, University of Otago, Dunedin, New Zealand.
11
University of Gezira, Wad Medani, Sudan.
12
Institute Pasteur Senegal Université Cheikh Anta Diop de Dakar, Senegal.
13
National Institute for Communicable Diseases School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
14
Centers for Disease Control and Prevention, Nairobi, Kenya.
15
Department of Infection Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg.
16
Institute of Tropical Medicine, Eberhard-Karls University Tübingen, Germany.
17
National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
18
Kenya Medical Research Institute, Nairobi, Kenya.
19
University of Antananarivo, Madagascar.
20
Institute of Medical Microbiology, University of Cologne, Germany.
21
Institut Supérieur des Sciences de la Population, University of Ouagadougou, Burkina Faso.

Abstract

BACKGROUND:

New immunization programs are dependent on data from surveillance networks and disease burden estimates to prioritize target areas and risk groups. Data regarding invasive Salmonella disease in sub-Saharan Africa are currently limited, thus hindering the implementation of preventive measures. The Typhoid Fever Surveillance in Africa Program (TSAP) was established by the International Vaccine Institute to obtain comparable incidence data on typhoid fever and invasive nontyphoidal Salmonella (iNTS) disease in sub-Saharan Africa through standardized surveillance in multiple countries.

METHODS:

Standardized procedures were developed and deployed across sites for study site selection, patient enrolment, laboratory procedures, quality control and quality assurance, assessment of healthcare utilization and incidence calculations.

RESULTS:

Passive surveillance for bloodstream infections among febrile patients was initiated at thirteen sentinel sites in ten countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania). Each TSAP site conducted case detection using these standardized methods to isolate and identify aerobic bacteria from the bloodstream of febrile patients. Healthcare utilization surveys were conducted to adjust population denominators in incidence calculations for differing healthcare utilization patterns and improve comparability of incidence rates across sites.

CONCLUSIONS:

By providing standardized data on the incidence of typhoid fever and iNTS disease in sub-Saharan Africa, TSAP will provide vital input for targeted typhoid fever prevention programs.

KEYWORDS:

Africa; invasive Salmonella disease; methodology; surveillance; typhoid fever

PMID:
26933028
PMCID:
PMC4772831
DOI:
10.1093/cid/civ693
[Indexed for MEDLINE]
Free PMC Article

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