Extensively drug-resistant typhoid fever in Pakistan (original) (raw)
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University of Michigan undergraduate research journal, 2024
Typhoidfeverisabacterialinfectionthatlargelyspreadsthroughcontaminationin foodandwater,aswellasbyclosecontact,anddisplaysmanycold-likesymptoms inadditiontomoreseveregastrointestinal,muscle,andlife-threateningstates.The emergenceofanew,extensivedrug-resistant(XDR)straininHyderabad,Pakistan, in 2016 resulted in the need for stronger antimicrobials to combat the pathogen. Despite vaccination and contact tracing interventions, the multi-drug resistance and fitness of the H58 strain Salmonella enterica serovar Typhi contributed to the rapidspreadoftyphoidfeverinPakistan.Vaccinationisattheforefrontofefforts attempting to combat XDR typhoid fever cases in Pakistan, and public education systems and schools should prioritize health classes that pertain to the spread of thediseaseandwhatstepsindividualscantaketobesafe,aswellassocialmedia infographicscirculatedthroughInstagramandFacebookwithpopularhashtagsto reachtargetaudiences.Arobustandforward-thinkingapproachneedstobetaken by the Pakistani government to use its budget and international funding in the sectorsofhealthandeducationtoensurediseaseprevention.
Typhoid burden, drug resistance and Pakistan’s stance against it
International Journal Of Community Medicine And Public Health, 2021
Salmonella typhi is a gram negative, rod shaped bacteria that features a polysaccharide capsule, flagella for motility and fimbria for adhesion to the epithelial cells of intestinal mucosa. The organism is responsible for causing enteric fever and in severe cases it leads to complications such as intestinal perforation which can lead to death. The mainstay of treatment of typhoid fever is antibiotic therapy but unfortunately the emergence of MDR (multidrug resistant) and XDR (extensively drug resistant) strains pose a major threat to the successful treatment of typhoid. Around 200,000 global deaths can be associated with typhoid and most cases are seen in low socioeconomic countries with inadequate healthcare infrastructure particularly those that are densely populated, among them Pakistan is considered as high-risk country according to WHO criteria. Prevention strategies include education of the masses regarding hand hygiene, cleanliness and consumption of clean food and water. In ...
A skeleton in the closet: The implications of COVID-19 on XDR strain of typhoid in Pakistan
Public Health in Practice, 2021
Extensively drug resistant typhoid fever is a major public health concern in Pakistan. During the COVID-19 pandemic, poor sanitation is leading typhoid cases to a surge and obsolete diagnostic methods are paving the way towards irrational pharmacotherapy. In particular, the overuse of azithromycin for the treatment of COVID-19 might impair one of the few remaining regimens against XDR. Facing COVID-19 and XDR at the same time can lead to a catastrophy, unless the government, the stakeholders and healthcare workers take joint action to improve sanitation, educate the public, vaccinate vulnerable groups and establish good diagnostic and management practices.
Extensively Drug-Resistant (XDR) Typhoid: Evolution, Prevention, and Its Management
BioMed Research International, 2020
Typhoid fever is the result of a human host-restricted Salmonella enteric serotype typhi infection that causes enteric fever. Around 21 million people contract typhoid annually, with Pakistan’s inhabitants at most risk amongst Asian countries where typhoid remains prevalent. Decades of indiscriminate antibiotic usage has driven the evolution of multidrug-resistant strains and more recently, extensively drug-resistant (XDR) strains of Salmonella enteric serotype typhi. Current reports of extensively drug-resistant typhoid fever outbreak in Pakistan are not only a major concern for Pakistan but also for health authorities worldwide: intercontinental transmission, spread, and replacement of native strains in neighboring countries and a major impediment to Pakistani health care management. The WHO records that there are 5274 cases of extensively drug-resistant (XDR) typhoid fever out of a total of 8188 total cases of typhoid fever reported in Pakistan. The last remaining feasible oral a...
Pakistan Armed Forces Medical Journal
Objective: To provide a laboratory-based surveillance report of typhoid fever cases diagnosed at a tertiary care hospital in Lahore during the ongoing outbreak. Study Design: Cross-sectional study. Place and Duration of Study: Department of Microbiology, Combined Military Hospital, Lahore Pakistan, from Mar 2018 to Jun 2019. Methodology: All positive blood culture samples that yielded the growth of Salmonella Typhi were included in the study. The samples were dealt with according to standard microbiological procedures. Antimicrobial susceptibility was performed using Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: During the study period, (377) Typhoidal Salmonellae were isolated, of which 327 (86.7%) were Salmonella Typhi and 50 (13.3%) were Paratyphi A. The percentage of XDR Salmonella isolates was 41.9%. Conclusion: Extensively drug-resistant typhoid fever cases reported in this study represent just the tip of an iceberg. Therefore, nationwide surveillance...
The American Journal of Tropical Medicine and Hygiene, 2022
ABSTRACT. Typhoid fever is endemic in Pakistan, with high annual incidence rates. An outbreak of extensively drug-resistant typhoid fever that first started in the Hyderabad district of Sindh province in November 2016 immediately spread to the whole province. We conducted an age-matched case–control study to assess the risk factors of typhoid fever in an outbreak setting of Lyari Town, Karachi. We enrolled 82 patients with blood culture-confirmed Salmonella typhi between August 2019 to December 2019, 82 age-matched hospital and 164 age-matched community control subjects. In a matched conditional logistic regression model, consumption of meals outside the home more than once per month was associated significantly with developing culture-confirmed typhoid fever compared with no consumption of food outside the home (odds ratio, 4.11). Hygiene of the environment in which food is prepared, practices of adult food handlers, access to clean water, and food legislation play significant role...