Antimicrobial Resistance

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Research indicates that multidrug resistant (MDR) typhoid strains have become increasingly common in typhoid high-burden communities, requiring new and more expensive antibiotics for treatment and increasing hospitalization rates for patients. Without appropriate antibiotic therapy, the mortality rate for typhoid can reach 20%.

Studies in Southeast Asia and sub-Saharan Africa have revealed a growing drug resistant strain of typhoid known as H58. Emerging 30 years ago in Asia, H58 cases have grown across Asia and spread to multiple African countries. Research from the Wellcome Trust illustrates the growth in Malawi, where in 2010 only 7% of typhoid cases were resistant to multiple drugs. In 2014, 97% of typhoid cases resisted treatment from multiple drugs.

Typhoid cases resistant to multiple drugs, Malawi 2010



Typhoid cases resistant to multiple drugs, Malawi 2014



The spread of drug-resistant typhoid will lead to increased costs of treatment and more complications, including death. Currently, if left untreated, 20% of typhoid cases are fatal. With treatment becoming ineffective against the disease, this number is expected to grow as H58 spreads.

So far, countries reporting drug resistant strains of typhoid include:

  1. Ghana
  2. Uganda
  3. Zambia
  4. Kuwait
  5. Cameroon
  6. Oman
  7. China
  8. Uzbekistan
  9. Qatar
  10. Tajikistan
  11. India (the remaining countries are from this article)
  12. Nepal
  13. Bangladesh
  14. Sri Lanka
  15. Pakistan
  16. Afghanistan
  17. Cambodia
  18. Myanmar
  19. Indonesia
  20. Laos
  21. Vietnam
  22. Thailand
  23. Lebanon
  24. Iraq
  25. Palestine
  26. Fiji
  27. Australia
  28. Kenya
  29. Malawi
  30. Tanzania
  31. South Africa