Multidrug resistant enteric fever in South Asia: unmet medical needs and opportunities


Christopher M Parry, Isabela Ribeiro, Kamini Walia, Priscilla Rupali, Stephen Baker, Buddha Basnyat


Enteric fever (typhoid) is the commonest bacterial bloodstream infection in South Asia. It is caused by Salmonella enterica serovars Typhi and Paratyphi A. Despite progress in controlling enteric fever in several parts of the world, it remains an important public health burden in South Asia. The incidence is estimated to be over 100 per 100 000 population. Around seven million people are affected each year in South Asia with about 75 000 deaths. However, these figures are likely to be an underestimate because of limitations in population based surveillance systems and reliable diagnostic methods. We discuss the challenges in managing enteric fever in South Asia in the context of growing antimicrobial resistance and highlight the need for sustained focus on improvements in diagnosis and treatment as part of an integrated control strategy.

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