{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:55:22Z","timestamp":1793382922855,"version":"4.5.0"},"reference-count":55,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T00:00:00Z","timestamp":1589846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T00:00:00Z","timestamp":1589846400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T00:00:00Z","timestamp":1589846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1151153"],"award-info":[{"award-number":["OPP1151153"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["T32 DK067872"],"award-info":[{"award-number":["T32 DK067872"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1151153"],"award-info":[{"award-number":["OPP1151153"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["T32 DK067872"],"award-info":[{"award-number":["T32 DK067872"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Typhoid fever incidence and complications, including intestinal perforation, have declined significantly in high\u2010income countries, with mortality rates &lt;1%. However, an estimated 10.9\u00a0million cases still occur annually, most in low\u2010 and middle\u2010income countries. With the availability of a new typhoid conjugate vaccine licensed for children and recommended by the World Health Organization, understanding severe complications, including associated mortality rates, is essential to inform country\u2010level decisions on introduction of this vaccine. This scoping review summarizes over 20 years of the literature on typhoid intestinal perforation in sub\u2010Saharan Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched EMBASE, PubMed, Medline, and Cochrane databases for studies reporting mortality rates due to typhoid intestinal perforation in children, under 18 years old, in sub\u2010Saharan Africa published from January 1995 through June 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010four papers from six countries were included. Reported mortality rates ranged from 4.6\u201375%, with 16 of the 24 studies between 11 and 30%. Thirteen papers included postoperative morbidity rates, ranging from 16\u2013100%. The most documented complications included surgical site infections, intra\u2010abdominal abscesses, and enterocutaneous fistulas. High mortality rates can be attributed to late presentation to tertiary centers, sepsis and electrolyte abnormalities requiring preoperative resuscitation, prolonged perforation\u2010to\u2010surgery interval, and lack of access to critical care or an intensive care unit postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Current estimates of mortality related to typhoid intestinal perforation among children in sub\u2010Saharan Africa remain unacceptably high. Prevention of typhoid fever is essential to reduce mortality, with the ultimate goal of a comprehensive approach that utilizes vaccination, improvements in water, sanitation, and hygiene, and greater access to surgical care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-020-05567-2","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T11:11:23Z","timestamp":1589886683000},"page":"2892-2902","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Morbidity and Mortality of Typhoid Intestinal Perforation Among Children in Sub\u2010Saharan Africa 1995\u20132019: A Scoping Review"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5746-1321","authenticated-orcid":false,"given":"Megan","family":"Birkhold","sequence":"first","affiliation":[{"name":"Department of Surgery University of Maryland School of Medicine 22 S. Greene St, S8B02 21201 Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yacaria","family":"Coulibaly","sequence":"additional","affiliation":[{"name":"Service de Chirurgie p\u00e9diatrique CHU Gabriel Tour\u00e9 Bamako Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oumar","family":"Coulibaly","sequence":"additional","affiliation":[{"name":"Service de Chirurgie p\u00e9diatrique CHU Gabriel Tour\u00e9 Bamako Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philadelphie","family":"Demb\u00e9l\u00e9","sequence":"additional","affiliation":[{"name":"Department of Surgery Koutiala Women's and Children's Hospital Koutiala Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery Koutiala Women's and Children's Hospital Koutiala Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samba","family":"Sow","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development \u2010 Mali Bamako Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen M.","family":"Neuzil","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health University of Maryland School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,19]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"CDC Yellow Book 2020: health information for international travel","author":"Appiah GD","year":"2019"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","unstructured":"World Health Organization(2018)Typhoid vaccines: WHO position paper March 2018","DOI":"10.1016\/j.vaccine.2018.04.022"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1353\/dem.2005.0002"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1229"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(18)30685\u20106"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i11.1925"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010018\u20104624\u20108"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.3.5665.273"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010197907000\u201000007"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022\u20103468(81)80867\u20106"},{"key":"e_1_2_9_12_1","first-page":"27","article-title":"Management of typhoid ileal perforation: a surgical experience of 44 cases","volume":"7","author":"Ansari AGAAG","year":"2009","journal-title":"Gomal J Med Sci"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.22442\/jlumhs.191830626"},{"key":"e_1_2_9_14_1","first-page":"22","article-title":"Results of typhoid perforation management: our experience in Bir Hospital","volume":"4","author":"Karmacharya B","year":"2006","journal-title":"Nepal Kathmandu Univ Med J"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.26452\/ijrps.v11i1.1875"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383\u2010002\u20100794\u20103"},{"key":"e_1_2_9_17_1","unstructured":"SAGE Working Group on Typhoid Vaccines & the WHO Secretariat(2017)Background paper to SAGE on typhoid vaccine policy recommendations"},{"key":"e_1_2_9_18_1","unstructured":"Gavi The Vaccine Alliance(2018)New typhoid vaccine to receive Gavi support. 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