Take on Typhoid June Newsletter

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In this issue:

Welcoming Dr. Matt Laurens: The new TyVAC Director

The Take on Typhoid team is excited to welcome Dr. Matt Laurens as the new Typhoid Vaccine Acceleration Consortium (TyVAC) Project Director. As a Professor of Pediatrics, Medicine, and Pathology at the Center for Vaccine Development and Global Health at the University of Maryland School of Medicine, Dr. Laurens has been an integral part of TyVAC since its inception. His passion for infectious diseases stems from a formative experience living in Benin, focusing on child vaccination projects and promoting improved water, sanitation, and hygiene (WASH). In his new role, Dr. Laurens envisions expanding on the previous successes of TyVAC—facilitating introduction of typhoid conjugate vaccines (TCVs) in endemic countries, reaching more audiences to highlight the importance of typhoid as a global health priority, and ensuring TCV data and tools are available for decision-makers.

Typhoid is costly for families and health systems

A recently published scoping review provides key information on the cost of typhoid illness. The review includes publications from studies in African and Asian countries. While absolute costs varied substantially across countries, subpopulations, and care settings, most studies characterized typhoid-related illness costs as catastrophic, meaning that the costs associated with typhoid illness require a substantial percentage of household income and are difficult for families to absorb. Additionally, cases treated in inpatient settings cost more than in outpatient settings, with intestinal perforation cases generally being most costly. While only one study included costs for drug-resistant typhoid cases specifically, it suggests that these cases are more expensive to treat than those that are sensitive to available antibiotics. As drug-resistant typhoid cases continue to increase, it is likely that treatment costs will also increase. By preventing typhoid cases, we not only protect the health of children, we also prevent the need for treatment and associated economic costs that studies show are generally catastrophic for families.

8.2 million more children vaccinated in Pakistan

In May, Pakistan conducted a TCV campaign in areas of Sindh Province to boost immunity and cover geographic areas, including rural communities, that were not reached in previous campaigns. TCV coverage rates vary across the country, and recent months have seen an increase in extensively drug resistant (XDR) cases reported in areas surrounding Karachi and Hyderabad. During the campaign, 8.2 million children 9 months to younger than 15 years old were identified and vaccinated in the peri urban and rural areas around Karachi and Hyderabad in Sindh province. Nearly 40 million children have now been vaccinated with TCVs through campaigns across Pakistan. This latest campaign is a testament to Pakistan’s continued commitment to protecting children from typhoid with TCVs. TCV remains available nationwide in the routine immunization schedule at the 9-month visit.

Improvements in WASH reduce the risk of typhoid

study conducted in a densely populated urban slum in Dhaka, Bangladesh, found an association between improvements in WASH facilities and a reduction in the risk of typhoid. The study identified households with private toilets, safe drinking water, and water filters and found these households have a 38% lower risk of contracting typhoid compared to households without these facilities. Particularly, children younger than age 10 who live in “better WASH” households are at the most reduced risk.

The study concluded that by improving WASH facilities, the spread of typhoid can be controlled. However, this requires time, resources, and a significant investment. It is important that policymakers prioritize the introduction of TCV – alongside WASH improvements – as these are the most impactful solutions to take on typhoid.

TyphiNET: Drug-resistant data to support TCV introduction decisions

TyphiNET is an interactive online dashboard that collates typhoid drug resistance and genotype data. The growing database already contains nearly 12,000 typhoid genomes from 101 countries. This data visualization tool provides country-level summaries of drug-resistant typhoid, from what strains are present in a country, to drug resistance trends for different antibiotic treatment options over time.

National-level drug resistance data can help make the case for investment in immunization programs. However, these data haven’t been consistently gathered. Existing data are often difficult to access, and interpret without a background in genomics. TyphiNET is an easy-to-use platform that combines available data in one place. Decision-makers can filter and analyze data from their country and/or region to better understand typhoid drug resistance trends and prevalence. This information can support new vaccine prioritization and decision-making for typhoid prevention and control strategies, including TCV introduction.

Congratulations are in order!

Please take a moment to congratulate our partners Dr. Nginache Nampota-Nkomba and Dr. Megan Carey on their recent accolades. Dr. Nampota-Nkomba, formerly of Blantyre Malaria Project, is the 2024 recipient of the National Foundation for Infectious Diseases Maurice R. Hilleman Early-Stage Career Investigator Award. This award recognizes promising scientists in the early stages of their careers in vaccinology.

Dr. Megan Carey received the 2024 London School of Hygiene & Tropical Medicine’s student AMR Center Publication Prize for her paper Global diversity and antimicrobial resistance of typhoid fever pathogens: Insights from a meta-analysis of 13,000 Salmonella Typhi genomes in eLife. This award is based on authorship role, scientific excellence, and impact in the field of antimicrobial resistance. We are proud to have these amazing women joining us to take on typhoid.

Scientific publications

Safety and immunogenicity of Vi-diphtheria toxoid typhoid conjugate vaccine among children below 2 years: a systematic review and meta-analysis

Uncovering the growing burden of enteric fever: A molecular analysis of Salmonella Typhi antimicrobial resistance

Bivalent conjugate vaccines for typhoid and paratyphoid fever

The safety and immunogenicity of a bivalent conjugate vaccine against Salmonella enterica Typhi and Paratyphi A in healthy Indian adults: a phase 1, randomised, active-controlled, double-blind trial

Visit our publications page for more recent research

Typhoid conjugate vaccine is an important preventative tool during times of water scarcity

Eliminating the risk of typhoid while confronting climate change

Typhoid intestinal perforations: valuable disease indicator in Francophone Africa

A ripple effect – navigating the waters of typhoid transmission

A third TCV receives WHO prequalification amidst rising rates of drug resistant typhoid

Understanding typhoid burden in Africa

The importance of inclusivity to take on typhoid

Immune response to TCV in Nepal

The opportunities and challenges that shaped Malawi’s integrated TCV campaign

Previous posts available on the blog