{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T02:47:37Z","timestamp":1785034057210,"version":"3.55.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"Supplement_3","license":[{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"vor","delay-in-days":30,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1113007"],"award-info":[{"award-number":["OPP1113007"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Typhoid fever is endemic in the urban Kathmandu Valley of Nepal; however, there have been no population-based studies of typhoid outside of this community in the past 3 decades. Whether typhoid immunization should be prioritized in periurban and rural communities has been unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed population-based surveillance for enteric fever in 1 urban catchment (Kathmandu) and 1 periurban and rural catchment (Kavrepalanchok) as part of the Surveillance for Enteric Fever in Asia Project (SEAP). We recruited individuals presenting to outpatient and emergency departments at 2 study hospitals with suspected enteric fever and performed blood cultures. Additionally, we conducted a household survey in each catchment area to characterize care seeking for febrile illness. We evaluated spatial heterogeneity in febrile illness, care seeking, and enteric fever incidence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between September 2016 and September 2019, we enrolled 5736 participants with suspected enteric fever at 2 study hospitals. Among these, 304 (5.3%) were culture positive for Salmonella Typhi (249 [81.9%]) or Paratyphi A (55 [18.1%]). Adjusted typhoid incidence in Kathmandu was 484 per 100 000 person-years and in Kavrepalanchok was 615 per 100 000 person-years. While all geographic areas for which estimates could be made had incidence &amp;gt;200 per 100 000 person-years, we observed spatial heterogeneity with up to 10-fold variation in incidence between communities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In urban, periurban, and rural communities in and around Kathmandu, we measured a high but heterogenous incidence of typhoid. These findings provide some support for the introduction of conjugate vaccines in Nepal, including outside urban areas, alongside other measures to prevent enteric fever.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1319","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T19:41:03Z","timestamp":1598989263000},"page":"S205-S213","source":"Crossref","is-referenced-by-count":13,"title":["Spatial Heterogeneity of Enteric Fever in 2 Diverse Communities in Nepal"],"prefix":"10.1093","volume":"71","author":[{"given":"Dipesh","family":"Tamrakar","sequence":"first","affiliation":[{"name":"Dhulikhel Hospital, Kathmandu University Hospital, Kavrepalanchok, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista","family":"Vaidya","sequence":"additional","affiliation":[{"name":"Dhulikhel Hospital, Kathmandu University Hospital, Kavrepalanchok, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander T","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Aiemjoy","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiva Ram","family":"Naga","sequence":"additional","affiliation":[{"name":"Dhulikhel Hospital, Kathmandu University Hospital, Kavrepalanchok, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanjia","family":"Cao","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caryn","family":"Bern","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Dhulikhel Hospital, Kathmandu University Hospital, Kavrepalanchok, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biraj M","family":"Karmacharya","sequence":"additional","affiliation":[{"name":"Dhulikhel Hospital, Kathmandu University Hospital, Kavrepalanchok, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sailesh","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah Naz","family":"Qamar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Saha","sequence":"additional","affiliation":[{"name":"Child Health Research Foundation, Department of Microbiology, Dhaka Shishu (Children\u2019s) Hospital, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kashmira","family":"Date","sequence":"additional","affiliation":[{"name":"Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley T","family":"Longley","sequence":"additional","affiliation":[{"name":"Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"National Foundation for the Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Hemlock","sequence":"additional","affiliation":[{"name":"Applied Epidemiology, Sabin Vaccine Institute, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Luby","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise O","family":"Garrett","sequence":"additional","affiliation":[{"name":"Applied Epidemiology, Sabin Vaccine Institute, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac I","family":"Bogoch","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5967-251X","authenticated-orcid":false,"given":"Jason R","family":"Andrews","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,1]]},"reference":[{"key":"2020120620560010900_CIT0001","first-page":"1365","article-title":"Typhoid fever, paratyphoid fever, and typhoidal fevers","volume-title":"Mandell, Douglas, and Bennett\u2019s principles and practice of infectious diseases","author":"Andrews","year":"2020"},{"key":"2020120620560010900_CIT0002","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S1473-3099(18)30685-6","article-title":"The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease 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