E-resources
Peer reviewed
Open access
-
Tadesse, Birkneh Tilahun; Khanam, Farhana; Ahmmed, Faisal; Im, Justin; Islam, Md Taufiqul; Kim, Deok Ryun; Kang, Sophie S Y; Liu, Xinxue; Chowdhury, Fahima; Ahmed, Tasnuva; Binte Aziz, Asma; Hoque, Masuma; Park, Juyeon; Pak, Gideok; Zaman, Khalequ; Khan, Ashraful Islam; Pollard, Andrew J; Kim, Jerome H; Marks, Florian; Qadri, Firdausi; Clemens, John D
Clinical infectious diseases, 11/2022, Volume: 75, Issue: 10Journal Article
Abstract Background Typhoid fever contributes to approximately 135 000 deaths annually. Achievable improvements in household water, sanitation, and hygiene (WASH) combined with vaccination using typhoid conjugate vaccines (TCVs) may be an effective preventive strategy. However, little is known about how improved WASH and vaccination interact to lower the risk of typhoid. Methods A total of 61 654 urban Bangladeshi children aged 9 months to <16 years, residing in 150 clusters with a baseline population of 205 760 residents, were randomized 1:1 by cluster to Vi-tetanus toxoid TCV or Japanese encephalitis (JE) vaccine. Surveillance for blood culture–confirmed typhoid fever was conducted over 2 years. Existing household WASH status was assessed at baseline as Better or Not Better using previously validated criteria. The reduction in typhoid risk among all residents associated with living in TCV clusters, Better WASH households, or both was evaluated using mixed-effects Poisson regression models. Results The adjusted reduced risk of typhoid among all residents living in the clusters assigned to TCV was 55% (95% confidence interval CI, 43%–65%; P < .001), and that of living in Better WASH households, regardless of cluster, was 37% (95% CI, 24%–48%; P < .001). The highest risk of typhoid was observed in persons living in households with Not Better WASH in the JE clusters. In comparison with these persons, those living in households with Better WASH in the TCV clusters had an adjusted reduced risk of 71% (95% CI, 59%–80%; P < .001). Conclusions Implementation of TCV programs combined with achievable and culturally acceptable household WASH practices were independently associated with a significant reduction in typhoid risk. Clinical Trials Registration ISRCTN11643110. Better preexisting household water, sanitation, and hygiene and delivering Vi-TT vaccine act independently to reduce typhoid risk, so that the combination of both yields greater protection against typhoid at the population level (71%) than either vaccination (55%) or improved WASH alone (37%).
Author
Shelf entry
Permalink
- URL:
Impact factor
Access to the JCR database is permitted only to users from Slovenia. Your current IP address is not on the list of IP addresses with access permission, and authentication with the relevant AAI accout is required.
Year | Impact factor | Edition | Category | Classification | ||||
---|---|---|---|---|---|---|---|---|
JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
Select the library membership card:
If the library membership card is not in the list,
add a new one.
DRS, in which the journal is indexed
Database name | Field | Year |
---|
Links to authors' personal bibliographies | Links to information on researchers in the SICRIS system |
---|
Source: Personal bibliographies
and: SICRIS
The material is available in full text. If you wish to order the material anyway, click the Continue button.