{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:56:25Z","timestamp":1787025385556,"version":"build-2736575974"},"reference-count":31,"publisher":"Scientific Scholar","content-domain":{"domain":["ijmr.org.in"],"crossmark-restriction":true},"short-container-title":["IJMR"],"abstract":"\n Background & objectives<\/jats:title>\n Burden estimates of enteric fever are required to make policy decisions on introducing typhoid vaccine in India. Incidence, antimicrobial susceptibility, and out-of-pocket expenditure (OOPE) of enteric fever are estimated in Chandigarh, India.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A hybrid (facility and community-based) surveillance system was set up at a secondary care hospital to enrol patients above six months of age, hospitalized with fever, from a defined catchment population from May 2018 to March 2020. Blood samples were collected and cultured using an automated system (BD BACTEC\n TM<\/jats:sup>\n blood culture system). The\n Salmonella Typhi<\/jats:italic>\n and\n S<\/jats:italic>\n .\n Paratyphi<\/jats:italic>\n isolates were characterized for antimicrobial susceptibility. OOPE was recorded after 14 and 28 days of discharge.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Blood samples were collected from 97 per cent of the 1650 study participants enrolled. The incidence of enteric fever was 226.8 per 1,00,000 person-years (PY), severe typhoid fever 156.9 per 1,00,000 PY, and severe paratyphoid fever 69.9 per 1,00,000 PY.\n Salmonella<\/jats:italic>\n was highly susceptible to ampicillin, azithromycin, and ceftriaxone (99.25%) and least susceptible to ciprofloxacin (11.3%). The OOPE due to hospitalization of individuals infected with\n S. Paratyphi<\/jats:italic>\n [INR 8696.6 (USD 116)] was significantly higher than the individuals infected with\n S. Typhi<\/jats:italic>\n [INR 7309 (USD 97.5),\n P<\/jats:italic>\n =0.01], and among cases who were hospitalized for more than seven days [INR 12,251 (USD 163.3)] as compared with those with a stay of 3-7 days [INR 8038.2 (USD 107.2)] or less than three days [INR 5327.8 (USD 71),\n P<\/jats:italic>\n <0.001].\n <\/jats:p>\n <\/jats:sec>\n \n Interpretation & conclusions<\/jats:title>\n There was a high incidence of enteric fever, high OOPE, and resistance to ciprofloxacin.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/ijmr_2080_22","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T12:28:12Z","timestamp":1725884892000},"page":"567-575","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Incidence, antimicrobial susceptibility & out of pocket expenditure of severe enteric fever in Chandigarh, north India"],"prefix":"10.25259","volume":"159","author":[{"given":"Madhu","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adarsh","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firoz","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Sagar","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Suri","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Advanced Paediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Guglani","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Government Medical College and Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidushi","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Government Medical College and Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadbhavna","family":"Pandit","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Government Multispecialty Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurinder","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Government Multispecialty Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Civil Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shankar","family":"Prinja","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, 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