期刊
CLINICAL INFECTIOUS DISEASES
卷 61, 期 -, 页码 S251-S258出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/civ710
关键词
transmission dynamics; Salmonella Typhi; H58 haplotype; multidrug resistance
资金
- Bill & Melinda Gates Foundation [OPP1116967]
- Strategic Award for Typhoid Research from Wellcome Trust [106158/Z/14/Z]
- RAPIDD program of Science and Technology Directorate, Department of Homeland Security
- Fogarty International Center, National Institutes of Health (NIH)
- Wellcome Trust [101113/Z/13/Z]
- Wellcome Trust [101113/Z/13/Z] Funding Source: Wellcome Trust
Background. Multiyear epidemics of Salmonella enterica serovar Typhi have been reported from countries across eastern and southern Africa in recent years. In Blantyre, Malawi, a dramatic increase in typhoid fever cases has recently occurred, and may be linked to the emergence of the H58 haplotype. Strains belonging to the H58 haplotype often exhibit multidrug resistance and may have a fitness advantage relative to other Salmonella Typhi strains. Methods. To explore hypotheses for the increased number of typhoid fever cases in Blantyre, we fit a mathematical model to culture-confirmed cases of Salmonella enterica infections at Queen Elizabeth Central Hospital, Blantyre. We explored 4 hypotheses: (1) an increase in the basic reproductive number (R-0) in response to increasing population density; (2) a decrease in the incidence of cross-immunizing infection with Salmonella Enteritidis; (3) an increase in the duration of infectiousness due to failure to respond to first-line antibiotics; and (4) an increase in the transmission rate following the emergence of the H58 haplotype. Results. Increasing population density or decreasing cross-immunity could not fully explain the observed pattern of typhoid emergence in Blantyre, whereas models allowing for an increase in the duration of infectiousness and/or the transmission rate of typhoid following the emergence of the H58 haplotype provided a good fit to the data. Conclusions. Our results suggest that an increase in the transmissibility of typhoid due to the emergence of drug resistance associated with the H58 haplotype may help to explain recent outbreaks of typhoid in Malawi and similar settings in Africa.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据