{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T18:38:27Z","timestamp":1789238307386,"version":"build-2803163510"},"reference-count":35,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3_Suppl","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9,6]]},"abstract":"<jats:p>A very high incidence of typhoid was described in studies conducted in urban locations on the Indian subcontinent at the end of the twentieth century. Despite their availability, licensed immunogenic conjugate typhoid vaccines have not been introduced in the national immunization program, in part, because of a lack of understanding of where and for whom prevention is most necessary. Uncertainty regarding the burden of disease is based on the lack of reliable, recent estimates of culture-confirmed typhoid and an observed trend of low isolations of <jats:italic>Salmonella<\/jats:italic> Typhi and fewer complications at large referral hospitals in India. In this article, we examine the trends of <jats:italic>S.<\/jats:italic> Typhi isolation at three large tertiary care centers across India over 15 years and describe trends of recognized risk factors for typhoid from published literature. There appears to be a decline in the isolation of <jats:italic>S.<\/jats:italic> Typhi in blood cultures, which is more apparent in the past 5 years. These trends are temporally related to economic improvement, female literacy, and the use of antibiotics such as cephalosporins and azithromycin. The analysis of trends of culture-confirmed typhoid may not accurately capture the typhoid incidence trends if antibiotic use confounds the burden of disease presenting to larger facilities. Emerging antimicrobial resistance may result in a resurgence of disease if the underlying incidence and transmission of typhoid are not adequately addressed through public health approaches.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0139","type":"journal-article","created":{"date-parts":[[2018,7,26]],"date-time":"2018-07-26T07:00:24Z","timestamp":1532588424000},"page":"34-40","source":"Crossref","is-referenced-by-count":41,"title":["Longitudinal Typhoid Fever Trends in India from 2000 to 2015"],"prefix":"10.4269","volume":"99","author":[{"given":"Veeraraghavan","family":"Balaji","sequence":"first","affiliation":[{"name":"Christian Medical College, Vellore, Tamil Nadu, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arti","family":"Kapil","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences, New Delhi, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayanthi","family":"Shastri","sequence":"additional","affiliation":[{"name":"TN Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agila Kumari","family":"Pragasam","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore, Tamil Nadu, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geeta","family":"Gole","sequence":"additional","affiliation":[{"name":"TN Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirshendu","family":"Choudhari","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore, Tamil Nadu, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gagandeep","family":"Kang","sequence":"additional","affiliation":[{"name":"Translational Health Sciences Technology Institute, Faridabad, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"John","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore, Tamil Nadu, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet Glob Health","first-page":"e570","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":"Mogasale","year":"2014"},{"key":"b2","series-title":"J Glob Health","first-page":"010401","article-title":"Typhoid fever and paratyphoid fever: systematic review to estimate global morbidity and mortality for 2010","volume":"2","author":"Buckle","year":"2010"},{"key":"b3","series-title":"Lancet","first-page":"2095","article-title":"Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Lozano","year":"2012"},{"key":"b4","series-title":"Bull World Health Organ","first-page":"260","article-title":"A study of typhoid fever in five Asian countries: disease burden and implications for controls","volume":"86","author":"Ochiai","year":"2008"},{"key":"b5","series-title":"N Engl J Med","first-page":"335","article-title":"A cluster-randomized effectiveness trial of Vi typhoid vaccine in India","volume":"361","author":"Sur","year":"2009"},{"key":"b6","series-title":"J Health Popul Nutr","first-page":"304","article-title":"Costs of illness due to typhoid fever in an Indian urban slum community: implications for vaccination policy","volume":"22","author":"Bahl","year":"2004"},{"key":"b7","series-title":"Lancet","first-page":"734","article-title":"Typhoid fever in children aged less than 5 years","volume":"354","author":"Sinha","year":"1999"},{"key":"b8","series-title":"Emerg Infect Dis","first-page":"326","article-title":"Bacteremic typhoid fever in children in an urban slum, Bangladesh","volume":"11","author":"Brooks","year":"2005"},{"key":"b9","series-title":"PLoS Negl Trop Dis","first-page":"e0004616","article-title":"The burden of typhoid and paratyphoid in India: systematic review and meta-analysis","volume":"10","author":"John","year":"2016"},{"key":"b10","series-title":"Indian Pediatr","first-page":"61","article-title":"Multidrug resistant typhoid fever: study of an outbreak in Calcutta","volume":"29","author":"Arora","year":"1992"},{"key":"b11","series-title":"Indian J Med Res","first-page":"431","article-title":"Occurrence & antibiogram of Salmonella typhi & S. 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