Citation Information :
Gupta BP, Saluja T, Sahastrabuddhe S. Epidemiology of Typhoid in Nepal: Review of Literature to Identify High Burden Area for Potential Use of Typhoid Vaccine. Pediatr Inf Dis 2021; 3 (2):51-56.
Aim and objective: Enteric fever has caused significant morbidity and will even get worse if the predisposing risk factors of the disease are not controlled. The rainy season accounts for the high incidence of enteric fever along with other diarrheal diseases in Nepal. This study aims to screen the high burden zone of typhoid cases in Nepal for the prospective use of typhoid conjugate vaccine for the disease.
Materials and methods: We searched Medline, Embase, Cochrane, and the World Health Organization (WHO) website for scientific literature published until December 2018. Additional publications identified through grey literature search, outbreak news-related online databases, and national reports from Nepal were reviewed. We summarized reported outbreaks of typhoid in Nepal by reported year, region, size of the outbreak, and major age group affected followed by the number of typhoid cases by year, region, and district reported to the Epidemiology and Disease Control Division (EDCD).
Results: Since the first report of the typhoid outbreak in 1984, there have been multiple publications describing typhoid in Nepal. Studies were conducted predominantly from Kathmandu valley during the rainy season; however, outbreaks have been reported at other parts of Nepal including Hilly and Mountain regions. While all age groups were affected by typhoid, children to young adults were frequently reported with the highest proportion. The data show that typhoid cases are on increase in all the five development regions (Eastern, Central, Western, Mid-Western, and Far-Western Development region), except in the far western region where the slight decrease was observed from 2013/2014 to 2014/2015 while an increasing trend was observed after 2015/2016.
Conclusion: We found typhoid cases are on increase and have become a pressing public health issue and concerned authorities should put their serious efforts to mitigate the problem. There are many challenges on the way to control the disease, inaccurate diagnosis, inadequate treatment, and increasing multidrug resistance are a few of them. A combined approach of vaccination and water, sanitation, and hygiene (WASH) may lead to a considerable drop in the incidence of this disease.
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