An appraisal of the clinical features of paediatric enteric fever including a systematic review and meta-analysis of the age stratified disease occurrence


Britto C, Pollard AJ, Voysey M, Blohmke CJ


Children bear a substantial proportion of the enteric fever disease burden in endemic areas. Controversy persistis regarding which age groups are most affected, leading to uncertainty about optimal intervention strategies. We performed a systematic review and meta-analysis of studies in Asia and Africa to compare the relative proportion of children with enteric fever in the <5 years, 5-9 years and 10-14 years age groups. Overall, studies conducted in Africa showed a relatively smaller occurrence of disease in the youngest age group, whereas in Asia the picture was more mixed with a very large degree of heterogeneity in estimates. The clinical features of enteric fever reviewed here differ between younger and older children and adults, likely leading to further uncertainty over disease burden. It is evident from our review that preschool children and infants also contribute a significant proportion of disease burden but haven’t been adequately targeted via vaccination programmes which have been focusing primarily on school-based vaccination campaigns.

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