Attachments
1.1. Worldwide case load and burden due to Typhoid
Typhoid fever continues to be a serious public health problem in many developing countries. The disease, which disproportionately strikes children, leads to serious complications, including hypotensive shock, perforation of the gut and gastrointestinal hemorrhage, in 10-15% of cases. Global estimates range from 17 to 22 million cases per year and 216,000 to 600,000 deaths. Even using the lower estimate, which is based on a conservative case fatality rate of 1%, (CFR reported from 1% to 4%), the number of typhoid-related deaths each year is comparable to that of cervical cancer caused by HPV and is greater than that of Japanese encephalitis and meningococcal meningitis. Which are the diseases included under vaccine preventable diseases and routine vaccination programmes are in practice in several countries but, although there is an effective vaccine available for Typhoid; it has not been prioritized yet.
Rapidly rising rates of antibiotic resistance documented in Asia have increased the difficulty and cost of treatment and threatens to increase the case fatality of the disease. At present, it is believed that 90% of the cases and deaths due to typhoid occur in Asia , where the disease is endemic.
The outbreaks of typhoid affect the population under the outbreak prone regions and local health system due to its prolonged natural history and complications. As mentioned earlier the cost of management for Typhoid cases is high and it might over burden the family of the patient and the health sector as well.