{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:25:25Z","timestamp":1767176725792,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013566","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000}}],"reference-count":56,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014718","name":"Innovative Research Group Project of the National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["NRF-2022R1A5A1033624 and NRF-2022R1C1C1006237"],"award-info":[{"award-number":["NRF-2022R1A5A1033624 and NRF-2022R1C1C1006237"]}],"id":[{"id":"10.13039\/100014718","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Government-wide R&D to Advance Infectious Disease Prevention and Control, Republic of Korea","award":["No. HG23C1629"],"award-info":[{"award-number":["No. HG23C1629"]}]},{"DOI":"10.13039\/100001125","name":"Gavi","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100001125","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Vaccine Alliance"},{"DOI":"10.13039\/100000865","name":"the Bill & Melinda Gates Foundation","doi-asserted-by":"crossref","award":["Grant Number OPP1157270 \/ INV-009125"],"award-info":[{"award-number":["Grant Number OPP1157270 \/ INV-009125"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>\n                    Typhoid fever remains a major public health threat in low- and middle-income countries (LMICs), where inadequate access to clean water and sanitation drives recurrent outbreaks. With antimicrobial resistance on the rise, the urgency of deploying preventive strategies such as typhoid conjugate vaccines (TCVs) have grown. In this study, we developed a dynamic compartmental model calibrated to the 2015 typhoid outbreak in Kampala, Uganda, to assess the health and economic outcomes of various outbreak response immunization (ORI) strategies using TCVs. We aimed to identify optimal ORI strategies that minimize cases and typhoid-related deaths as well as the costs of implementation. Our model incorporated different phases of the outbreak, vaccine coverage levels (30%, 50%, 70%), timing (early, late, combined), and campaign duration. Cost-effectiveness was evaluated based on disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (ICERs), using World Health Organization (WHO) thresholds derived from Uganda\u2019s 2015 gross national income per capita. Early, high-coverage vaccination (Scenario 1) was most impactful reducing the effective reproduction number (\n                    <jats:italic>\n                      <jats:italic>R<\/jats:italic>\n                    <\/jats:italic>\n                    <jats:sub>t<\/jats:sub>\n                    ) below 1 during the epidemic peak and averting over 7,000 cases including 180 deaths. The timing of vaccine deployment was the most critical determinant of effectiveness, followed by coverage level and campaign duration. Our findings highlight the importance of rapid, high-coverage TCV deployment at the early stages of an outbreak. Strengthening disease surveillance and improving vaccine logistics are essential for a timely response. This modeling framework offers actionable evidence to support policy development and optimize outbreak preparedness in typhoid-endemic regions.\n                  <\/jats:p>","DOI":"10.1371\/journal.pntd.0013566","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T17:54:08Z","timestamp":1759859648000},"page":"e0013566","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effective strategies for typhoid conjugate vaccine delivery: Health and economic insights from the 2015 Kampala outbreak"],"prefix":"10.1371","volume":"19","author":[{"given":"Yeonsu","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela Kim N.","family":"Salonga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changdae","family":"Son","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geunsoo","family":"Jang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae-Hyup","family":"Koh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong-Hoon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9880-3044","authenticated-orcid":true,"given":"Hyojung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"issue":"4","key":"pntd.0013566.ref001","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1128\/CMR.00002-15","article-title":"Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections","volume":"28","author":"JA Crump","year":"2015","journal-title":"Clin Microbiol Rev"},{"issue":"4","key":"pntd.0013566.ref002","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":"GBD 2017 Typhoid and Paratyphoid Collaborators.","year":"2019","journal-title":"Lancet Infect Dis"},{"issue":"10","key":"pntd.0013566.ref003","article-title":"Updated estimates of typhoid fever burden in sub-Saharan Africa","volume":"5","author":"J-H Kim","year":"2017","journal-title":"Lancet Glob Health"},{"issue":"10","key":"pntd.0013566.ref004","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(14)70301-8","article-title":"Burden of typhoid fever in low-income and middle-income countries: a systematic, literature-based update with risk-factor adjustment","volume":"2","author":"V Mogasale","year":"2014","journal-title":"Lancet Glob Health"},{"issue":"2","key":"pntd.0013566.ref005","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0005376","article-title":"The burden of typhoid fever in low- and middle-income countries: A meta-regression approach","volume":"11","author":"M Antill\u00f3n","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013566.ref006","unstructured":"World Health Organization. Typhoid. 2023 [cited 2025 Sep 15]. In: WHO. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/typhoid"},{"key":"pntd.0013566.ref007","article-title":"Typhoid fever vaccination strategies","volume":"33","author":"KA Date","year":"2015","journal-title":"Vaccine"},{"key":"pntd.0013566.ref008","unstructured":"World Health Organization. Comparison table of WHO prequalified typhoid conjugate vaccines (TCV). 2021 [cited 2024 May 21]. In: WHO. Available from: https:\/\/iris.who.int\/handle\/10665\/345367"},{"key":"pntd.0013566.ref009","unstructured":"World Health Organization. SKYTyphoid Multi Inj. 2024 [cited 2025 Sep 15]. In: WHO - Prequalification of Medical Products (IVDs, Medicines, Vaccines and Immunization Devices, Vector Control). 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