Estimating typhoid incidence from community-based serosurveys: a multicohort study.
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Aiemjoy Kristen, Seidman Jessica C, Saha Senjuti, Munira Sira Jam, Islam Sajib Mohammad Saiful, Sium Syed Muktadir Al, Sarkar Anik, Alam Nusrat, Zahan Farha Nusrat, Kabir Md Shakiul, Tamrakar Dipesh, Vaidya Krista, Shrestha Rajeev, Shakya Jivan, Katuwal Nishan, Shrestha Sony, Yousafzai Mohammad Tahir, Iqbal Junaid, Dehraj Irum Fatima, Ladak Yasmin, Maria Noshi, Adnan Mehreen, Pervaiz Sadaf, Carter Alice S, Longley Ashley T, Fraser Clare, Ryan Edward T, Nodoushani Ariana, Fasano Alessio, Leonard Maureen M, Kenyon Victoria, Bogoch Isaac I, Jeon Hyon Jin, Haselbeck Andrea, Park Se Eun, Zellweger Raphaël M, Marks Florian, Owusu-Dabo Ellis, Adu-Sarkodie Yaw, Owusu Michael, Teunis Peter, Luby Stephen P, Garrett Denise O, Qamar Farah Naz, Saha Samir K, Charles Richelle C, Andrews Jason R
Аннотация
METHODS: We collected longitudinal blood samples from patients with blood culture-confirmed enteric fever enrolled from surveillance studies in Bangladesh, Nepal, Pakistan, and Ghana between 2016 and 2021 and conducted cross-sectional serosurveys in the catchment areas of each surveillance site. We used ELISAs to measure quantitative IgA and IgG antibody responses to hemolysin E and S Typhi lipopolysaccharide. We used Bayesian hierarchical models to fit two-phase power-function decay models to the longitudinal antibody responses among enteric fever cases and used the joint distributions of the peak antibody titres and decay rate to estimate population-level incidence rates from cross-sectional serosurveys.
FINDINGS: The longitudinal antibody kinetics for all antigen-isotypes were similar across countries and did not vary by clinical severity. The seroincidence of typhoidal Salmonella infection among children younger than 5 years ranged between 58·5 per 100 person-years (95% CI 42·1-81·4) in Dhaka, Bangladesh, to 6·6 per 100 person-years (4·3-9·9) in Kavrepalanchok, Nepal, and followed the same rank order as clinical incidence estimates.
INTERPRETATION: The approach described here has the potential to expand the geographical scope of typhoidal Salmonella surveillance and generate incidence estimates that are comparable across geographical regions and time.
FUNDING: Bill & Melinda Gates Foundation.
TRANSLATIONS: For the Nepali, Bengali and Urdu translations of the abstract see Supplementary Materials section.