{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T11:29:35Z","timestamp":1775561375102,"version":"3.50.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"Supplement_5","license":[{"start":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T00:00:00Z","timestamp":1637625600000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["ID\u2013INV-009497-OPP1159351"],"award-info":[{"award-number":["ID\u2013INV-009497-OPP1159351"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Christian Medical College Vellore Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The case-fatality ratio (CFR) for enteric fever is essential for estimating disease burden and calibrating measures that balance the likely health gains from interventions against social and economic costs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We aimed to estimate the CFR for enteric fever using multiple data sources within the National Surveillance System for Enteric Fever in India. This surveillance (2017\u20132020) was established as a multitiered surveillance system including community cohorts (tier 1), facility-based (tier 2), and tertiary care surveillance (tier 3) for estimating the burden of enteric fever in India. The CFR was calculated after accounting for healthcare-seeking behavior for enteric fever and deaths occurring outside the hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1236 hospitalized patients with blood culture\u2013confirmed enteric fever were enrolled, of which 9 fatal cases were identified, for an estimated hospitalized CFR of 0.73% (95% confidence interval [CI], .33%\u20131.38%). After adjusting for severity, healthcare-seeking behavior, and deaths occurring out-of-hospital, the CFR was estimated to be 0.16% (95% CI, .07%\u2013.29%) for all enteric fevers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our estimates of the CFR are relatively lower than previously estimated, accounting for care-seeking behavior and deaths outside the hospital.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiab388","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T19:09:41Z","timestamp":1627067381000},"page":"S517-S521","source":"Crossref","is-referenced-by-count":8,"title":["Case-Fatality Ratio of Enteric Fever: Estimates From Multitiered Surveillance in India"],"prefix":"10.1093","volume":"224","author":[{"given":"Prasanna","family":"Samuel","sequence":"first","affiliation":[{"name":"Christian Medical College, Vellore,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swathi Krishna","family":"Njarekkattuvalappil","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7247-537X","authenticated-orcid":false,"given":"Reshma","family":"Raju","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason R","family":"Andrews","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Stanford, California,USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3656-564X","authenticated-orcid":false,"given":"Gagandeep","family":"Kang","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore,India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3654-5099","authenticated-orcid":false,"given":"Jacob","family":"John","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore,India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,11,23]]},"reference":[{"key":"2022030311110979100_CIT0001","volume-title":"Modern epidemiology","author":"Rothman","year":"1998"},{"key":"2022030311110979100_CIT0002","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1093\/cid\/civ976","article-title":"Challenges and opportunities for typhoid fever control: a call for coordinated action","volume":"62","author":"Steele","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2022030311110979100_CIT0003","doi-asserted-by":"crossref","first-page":"C16","DOI":"10.1016\/j.vaccine.2015.03.103","article-title":"Challenges in measuring complications and death due to invasive Salmonella infections","volume":"33","author":"Qamar","year":"2015","journal-title":"Vaccine"},{"key":"2022030311110979100_CIT0004","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 study 2017","volume":"19","author":"Stanaway","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"2022030311110979100_CIT0005","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1093\/cid\/ciy190","article-title":"Case fatality rate of enteric fever in endemic countries: a systematic review and meta-analysis","volume":"67","author":"Pieters","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2022030311110979100_CIT0006","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1186\/s12889-018-5498-2","article-title":"Estimating the incidence of enteric fever in children in India: a multi-site, active fever surveillance of pediatric cohorts","volume":"18","author":"John","year":"2018","journal-title":"BMC Public Health"},{"key":"2022030311110979100_CIT0007","article-title":"Estimating the incidence rate of enteric (typhoid) fever in India through a multi-center surveillance network of secondary care centers","author":"John"},{"key":"2022030311110979100_CIT0008","doi-asserted-by":"crossref","first-page":"S222","DOI":"10.1093\/infdis\/jiy543","article-title":"Case-fatality ratio of blood culture\u2013confirmed typhoid fever in Dhaka, Bangladesh","volume":"218","author":"Yu","year":"2018","journal-title":"J Infect 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