Tropical medicine & international health : TM & IH · 2026
Resurgence of Typhoid Fever in Ghana: A Scoping Review of Epidemiology, Antimicrobial Resistance Patterns, Geographic Distribution, and Public Health Interventions.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Twumasi Stephen, Ansah Richard Owusu, Abubakari Abdul Wasid, Ayirebi Allwell Adofo, Dankwah Bright Opoku, Opoku Angela
Аннотация
BACKGROUND: Typhoid fever remains a major public health threat in Ghana, where the intensification of a long-standing endemic challenge is driving a re-emergence of the disease. This resurgence is fuelled by a complex interplay of escalating antimicrobial resistance (AMR), inadequate water and sanitation (WASH) infrastructure, and persistent diagnostic limitations. This scoping review provides a comprehensive synthesis of the current evidence on the epidemiology, AMR patterns, diagnosis, treatment and public health interventions for typhoid fever in Ghana.
METHODS: A systematic scoping review of peer-reviewed literature, national surveillance data and public health reports from January 2010 to August 2025 was conducted using databases including PubMed, Scopus and institutional repositories.
RESULTS: The incidence of typhoid fever remains high, with significant outbreaks in regions like Oti linked to environmental degradation from illegal mining. A critical shift in antimicrobial resistance is observed, with widespread resistance to first-line agents now compounded by emerging resistance to ciprofloxacin and decreased susceptibility to third-generation cephalosporins. Diagnostics remain a major challenge, with an over-reliance on the unreliable Widal test and underutilization of blood culture, which fuels a cycle of misdiagnosis and inappropriate antibiotic use. While public health interventions like WASH improvements and typhoid conjugate vaccine (TCV) rollouts are underway, they face significant logistical and financial hurdles to full implementation.
CONCLUSION: The re-emergence of typhoid fever in Ghana is a complex public health crisis demanding an integrated response. Addressing this challenge requires strengthening diagnostic capacity, enforcing antimicrobial stewardship, accelerating TCV implementation, and making sustained investments in WASH infrastructure to break the cycle of transmission.
METHODS: A systematic scoping review of peer-reviewed literature, national surveillance data and public health reports from January 2010 to August 2025 was conducted using databases including PubMed, Scopus and institutional repositories.
RESULTS: The incidence of typhoid fever remains high, with significant outbreaks in regions like Oti linked to environmental degradation from illegal mining. A critical shift in antimicrobial resistance is observed, with widespread resistance to first-line agents now compounded by emerging resistance to ciprofloxacin and decreased susceptibility to third-generation cephalosporins. Diagnostics remain a major challenge, with an over-reliance on the unreliable Widal test and underutilization of blood culture, which fuels a cycle of misdiagnosis and inappropriate antibiotic use. While public health interventions like WASH improvements and typhoid conjugate vaccine (TCV) rollouts are underway, they face significant logistical and financial hurdles to full implementation.
CONCLUSION: The re-emergence of typhoid fever in Ghana is a complex public health crisis demanding an integrated response. Addressing this challenge requires strengthening diagnostic capacity, enforcing antimicrobial stewardship, accelerating TCV implementation, and making sustained investments in WASH infrastructure to break the cycle of transmission.