Typhoid fever surveillance has been done in Madagascar since 2011 as part of the Typhoid Fever Surveillance in Africa Program (TSAP) and the Febrile Illnesses Surveillance in Africa Program. TSAP identified an incidence of 171 per 100,000 individuals aged 5–14 years in a rural setting, corresponding to five typhoid cases in a study population of 13,188 individuals. Madagascar ranks 112th of 117 countries investigated for water, hygiene, and sanitation (WASH) performance, 40% of the population openly defecate and, in rural settings, only 35% of the population have access to water.
Introduction of typhoid conjugate vaccine will greatly benefit the Malagasy population. National immunization circumvents the WASH and health-care system shortfalls and will protect the population from an often deadly disease. This important measure will protect thousands of Malagasy children who have inadequate access to appropriate health care and water.
Click here to view the article, published in The Lancet.