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We sought to describe a decade of typhoid fever incidence in the Kilimanjaro Region of Tanzania. Cases of blood culture confirmed typhoid were identified among febrile patients at two sentinel hospitals during three study periods: 2007\u201308, 2011\u201314, and 2016\u201318. To account for under-ascertainment at sentinel facilities, we derived adjustment multipliers from healthcare utilization surveys done in the hospital catchment area. Incidence estimates and credible intervals (CrI) were derived using a Bayesian hierarchical incidence model that incorporated uncertainty of our observed typhoid fever prevalence, of healthcare seeking adjustment multipliers, and of blood culture diagnostic sensitivity. Among 3,556 total participants, 50 typhoid fever cases were identified. Of typhoid cases, 26 (52%) were male and the median (range) age was 22 (&lt;1\u201360) years; 4 (8%) were aged &lt;5 years and 10 (20%) were aged 5 to 14 years. Annual typhoid fever incidence was estimated as 61.5 (95% CrI 14.9\u2013181.9), 6.5 (95% CrI 1.4\u201320.4), and 4.0 (95% CrI 0.6\u201313.9) per 100,000 persons in 2007\u201308, 2011\u201314, and 2016\u201318, respectively. There were no deaths among typhoid cases. We estimated moderate typhoid incidence (\u226510 per 100\u2008000) in 2007\u201308 and low (&lt;10 per 100\u2008000) incidence during later surveillance periods, but with overlapping credible intervals across study periods. Although consistent with falling typhoid incidence, we interpret this as showing substantial variation over the study periods. Given potential variation, multi-year surveillance may be warranted in locations making decisions about typhoid conjugate vaccine introduction and other control measures.<\/jats:p>","DOI":"10.1371\/journal.pntd.0010516","type":"journal-article","created":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T18:18:08Z","timestamp":1657045088000},"page":"e0010516","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Facility-based disease surveillance and Bayesian hierarchical modeling to estimate endemic typhoid fever incidence, Kilimanjaro Region, Tanzania, 2007\u20132018"],"prefix":"10.1371","volume":"16","author":[{"given":"Elena R.","family":"Cutting","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan 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