{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T21:48:31Z","timestamp":1787003311113,"version":"build-2736575974"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":37,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100010269","name":"Welcome Trust","doi-asserted-by":"crossref","award":["222044\/Z\/20\/Z"],"award-info":[{"award-number":["222044\/Z\/20\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Vaccines"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This study, grounded in the key stakeholders\u2019 perspectives, highlights the critical and immediate need for the development of a new iNTS vaccine. An online survey was conducted among government officials and healthcare providers across eight African countries: Burkina Faso, the Democratic Republic of Congo, Ethiopia, Ghana, Kenya, Malawi, Mozambique, and Nigeria. The framework was built on Spring Boot and Java 8, enabling access via personal computers or mobile phones. A total of 74 out of 84 participants completed the survey. Over 50% indicated that iNTS is both a prevalent and serious disease in their respective countries. The majority (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200970, 94.6%) identified antibiotics as the most effective treatment for iNTS disease, while 55 (67.6%) participants chose vaccination as the preferred preventive option. Respondents ranked the iNTS vaccine third. Notably, 75.7% (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200956) emphasized the urgent need for an iNTS vaccine. Barriers to vaccine introduction were identified as insufficient funding (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200961, 81.4%), limited awareness (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200949, 79.7%), and challenges related to community acceptance (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200949, 79.7%). The stakeholders\u2019 perspectives highlight an urgent need for iNTS vaccine development. Accelerated and focused efforts are essential to address the reported pressing challenges and to pursue innovative and promising pathways for advancing iNTS vaccine development.\n                  <\/jats:p>","DOI":"10.1038\/s41541-026-01391-2","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:16:55Z","timestamp":1770812215000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Need, demand, and feasibility for a new iNTS vaccine: stakeholder insights from eight African countries"],"prefix":"10.1038","volume":"11","author":[{"given":"Sajan","family":"Gunarathna","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongha","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Seok","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GeunHyeog","family":"Jang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis","family":"Excler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Marks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome H.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"1391_CR1","unstructured":"Orphanet. Knowledge on rare diseases and orphan drugs: Invasive Non Typhoidal Salmonella. <https:\/\/www.orpha.net\/en\/disease\/detail\/324648?name=invasive%20non%20typhoidal%20salmonella&mode=name> (2017)."},{"key":"1391_CR2","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1128\/CMR.00002-15","volume":"28","author":"JA Crump","year":"2015","unstructured":"Crump, J. A., Sjolund-Karlsson, M., Gordon, M. A. & Parry, C. M. Epidemiology, clinical presentation, laboratory diagnosis, antimicrobial resistance, and antimicrobial management of invasive Salmonella infections. Clin. Microbiol. Rev. 28, 901\u2013937 (2015).","journal-title":"Clin. Microbiol. Rev."},{"key":"1391_CR3","unstructured":"Education, O. V. G.-C. V. R. A. I. Invasive Non-typhoidal Salmonella disease. <https:\/\/www.ovg.ox.ac.uk\/research\/invasive-non-typhoidal-salmonella-disease> (n.d.)."},{"key":"1391_CR4","unstructured":"World Health Organization. Immunization, Vaccines and Biologicals - Nontyphoidal Salmonella Disease. <https:\/\/www.who.int\/teams\/immunization-vaccines-and-biologicals\/diseases\/nontyphoidal-salmonella-disease> (2022)."},{"key":"1391_CR5","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.1016\/S1473-3099(19)30418-9","volume":"19","author":"G. B. D. Non-Typhoidal Salmonella Invasive Disease Collaborators","year":"2019","unstructured":"G. B. D. Non-Typhoidal Salmonella Invasive Disease Collaborators The global burden of non-typhoidal salmonella invasive disease: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Infect. Dis. 19, 1312\u20131324 (2019).","journal-title":"Lancet Infect. Dis."},{"key":"1391_CR6","doi-asserted-by":"publisher","first-page":"2256","DOI":"10.1017\/S0950268812000088","volume":"140","author":"PL Chen","year":"2012","unstructured":"Chen, P. L. et al. Epidemiology, disease spectrum and economic burden of non-typhoidal Salmonella infections in Taiwan, 2006\u20132008. Epidemiol. Infect. 140, 2256\u20132263 (2012).","journal-title":"Epidemiol. Infect."},{"key":"1391_CR7","doi-asserted-by":"publisher","unstructured":"Emary, K. et al. Landscape analysis of invasive non-typhoidal Salmonella (iNTS) disease and iNTS vaccine use case and demand: Report of a WHO expert consultation. Vaccine 10 https:\/\/doi.org\/10.1016\/j.vaccine.2025.127008 (2025)","DOI":"10.1016\/j.vaccine.2025.127008"},{"key":"1391_CR8","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1056\/NEJMoa040275","volume":"352","author":"JA Berkley","year":"2005","unstructured":"Berkley, J. A. et al. Bacteremia among children admitted to a rural hospital in Kenya. N. Engl. J. Med. 352, 39\u201347 (2005).","journal-title":"N. Engl. J. Med."},{"key":"1391_CR9","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1097\/01.inf.0000226839.30925.a5","volume":"25","author":"G Enwere","year":"2006","unstructured":"Enwere, G. et al. Epidemiologic and clinical characteristics of community-acquired invasive bacterial infections in children aged 2\u201329 months in The Gambia. Pediatr. Infect. Dis. J. 25, 700\u2013705 (2006).","journal-title":"Pediatr. Infect. Dis. J."},{"key":"1391_CR10","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1111\/j.1365-3156.2009.02326.x","volume":"14","author":"Q Bassat","year":"2009","unstructured":"Bassat, Q. et al. Severe malaria and concomitant bacteraemia in children admitted to a rural Mozambican hospital. Trop. Med. Int. Health 14, 1011\u20131019 (2009).","journal-title":"Trop. Med. Int. Health"},{"key":"1391_CR11","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/S1473-3099(10)70072-4","volume":"10","author":"EA Reddy","year":"2010","unstructured":"Reddy, E. A., Shaw, A. V. & Crump, J. A. Community-acquired bloodstream infections in Africa: a systematic review and meta-analysis. Lancet Infect. Dis. 10, 417\u2013432 (2010).","journal-title":"Lancet Infect. Dis."},{"key":"1391_CR12","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1086\/529146","volume":"46","author":"MA Gordon","year":"2008","unstructured":"Gordon, M. A. et al. Epidemics of invasive Salmonella enterica serovar enteritidis and S. enterica Serovar typhimurium infection associated with multidrug resistance among adults and children in Malawi. Clin. Infect. Dis. 46, 963\u2013969 (2008).","journal-title":"Clin. Infect. Dis."},{"key":"1391_CR13","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1093\/oxfordjournals.bmb.a011695","volume":"54","author":"CF Gilks","year":"1998","unstructured":"Gilks, C. F. Acute bacterial infections and HIV disease. Br. Med. Bull. 54, 383\u2013393 (1998).","journal-title":"Br. Med. Bull."},{"key":"1391_CR14","first-page":"626","volume":"39","author":"JJ van Oosterhout","year":"2005","unstructured":"van Oosterhout, J. J. et al. A community-based study of the incidence of trimethoprim-sulfamethoxazole-preventable infections in Malawian adults living with HIV. Acquir Immune Defic Syndr. 39, 626\u2013631 (2005).","journal-title":"Acquir Immune Defic Syndr."},{"key":"1391_CR15","unstructured":"HyonJin, J. The Burden of Invasive Non-Typhoidal Salmonella Disease in Six Sites in Africa: Results from the Severe Typhoid Surveillance in Africa Progra. <https:\/\/www.coalitionagainsttyphoid.org\/wp-content\/uploads\/2024\/01\/8_iNTS_HyonJin-Jeon.pdf> (2023)."},{"key":"1391_CR16","doi-asserted-by":"publisher","unstructured":"Park, S. E. et al. The genomic epidemiology of multi-drug resistant invasive non-typhoidal Salmonella in selected sub-Saharan African countries. BMJ Glob. Health 6 https:\/\/doi.org\/10.1136\/bmjgh-2021-005659 (2021).","DOI":"10.1136\/bmjgh-2021-005659"},{"key":"1391_CR17","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1093\/cid\/ciac035","volume":"75","author":"J Fierer","year":"2022","unstructured":"Fierer, J. Invasive Non-typhoidal Salmonella (iNTS) Infections. Clin. Infect. Dis. 75, 732\u2013738 (2022).","journal-title":"Clin. Infect. Dis."},{"key":"1391_CR18","doi-asserted-by":"publisher","unstructured":"Excler, J. L. et al. Non-typhoidal Salmonella combination vaccines: clinical development plan and regulatory considerations. Vaccine 62 https:\/\/doi.org\/10.1016\/j.vaccine.2025.127515 (2025).","DOI":"10.1016\/j.vaccine.2025.127515"},{"key":"1391_CR19","doi-asserted-by":"publisher","first-page":"e076477","DOI":"10.1136\/bmjopen-2023-076477","volume":"14","author":"C Smith","year":"2024","unstructured":"Smith, C. et al. Protocol for the challenge non-typhoidal Salmonella (CHANTS) study: a first-in-human, in-patient, double-blind, randomised, safety and dose-escalation controlled human infection model in the UK. BMJ Open 14, e076477 (2024).","journal-title":"BMJ Open"},{"key":"1391_CR20","unstructured":"The Boston Consulting Group. & Welcome. Read the report: vaccines for AMR. <https:\/\/vaccinesforamr.org\/read-the-report\/> (n.d)"},{"key":"1391_CR21","unstructured":"Institute for Health Metrics and Evaluation (IHME). <https:\/\/vizhub.healthdata.org\/gbd-results\/> (2023)."},{"key":"1391_CR22","doi-asserted-by":"publisher","first-page":"S339","DOI":"10.1093\/cid\/civ712","volume":"61","author":"I Mandomando","year":"2015","unstructured":"Mandomando, I. et al. Invasive Salmonella infections among children from rural Mozambique, 2001-2014. Clin. Infect. Dis. 61, S339\u2013S345 (2015).","journal-title":"Clin. Infect. Dis."},{"key":"1391_CR23","unstructured":"World Health Organization. New Report Calls for Urgent Action to Avert Antimicrobial Resistance Crisis. <https:\/\/www.who.int\/news\/item\/29-04-2019-new-report-calls-for-urgent-action-to-avert-antimicrobial-resistance-crisis> (2019)."},{"key":"1391_CR24","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1080\/14760584.2023.2270596","volume":"22","author":"PD Skidmore","year":"2023","unstructured":"Skidmore, P. D., Canals, R. & Ramasamy, M. N. The iNTS-GMMA vaccine: a promising step in non-typhoidal Salmonella vaccine development. Expert Rev. Vaccines 22, 918\u2013920 (2023).","journal-title":"Expert Rev. Vaccines"},{"key":"1391_CR25","unstructured":"World Health Organization. Progress in Polio Eradication in Africa. <https:\/\/www.afro.who.int\/news\/progress-polio-eradication-africa> (2022)."},{"key":"1391_CR26","unstructured":"World Health Organization. Vaccines Prequalification Priority List 2024 - 2026. <https:\/\/extranet.who.int\/prequal\/vaccines\/vaccines-eligible-who-prequalification> (2023)."},{"key":"1391_CR27","unstructured":"Gavi: The Vaccine Alliance. African Vaccine Manufacturing Accelerator (AVMA) Guidance for Manufacturers. <https:\/\/www.gavi.org\/programmes-impact\/types-support\/regional-manufacturing-strategy\/avma> (2024)."},{"key":"1391_CR28","unstructured":"World Health Organization. What is Africa\u2019s vaccine production capacity?. <https:\/\/www.afro.who.int\/news\/what-africas-vaccine-production-capacity> (2021)."},{"key":"1391_CR29","unstructured":"World Health Organization. Risks and challenges in Africa\u2019s COVID-19 vaccine rollout. <https:\/\/www.afro.who.int\/news\/risks-and-challenges-africas-covid-19-vaccine-rollout> (2021)."},{"key":"1391_CR30","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","volume":"61","author":"EE Von","year":"2008","unstructured":"Von, E. E. et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)statement: guidelines for reporting observational studies. J. Clin. Epidemiol. 61, 344\u2013349 (2008).","journal-title":"J. Clin. Epidemiol."}],"container-title":["npj Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41541-026-01391-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41541-026-01391-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41541-026-01391-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T11:06:34Z","timestamp":1774004794000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41541-026-01391-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1391"],"URL":"https:\/\/doi.org\/10.1038\/s41541-026-01391-2","relation":{},"ISSN":["2059-0105"],"issn-type":[{"value":"2059-0105","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,11]]},"assertion":[{"value":"23 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Voluntary informed consent was asked at the beginning of the survey. All participants were able to go through the study objectives, aims, and procedures of the survey prior to the confirmation of voluntary informed consent. Email information which was encrypted was taken to prevent any duplicated information from the same participant and to allow participants to sign back into the survey if they could not finish the survey at once.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"64"}}