Enteric fever Infections and Infestations
Conditions
Interventions
?1. A population census of ~100,000 individuals to establish baseline demographic data on a per household basis
to be updated at regular intervals with migration, births and deaths during the study period. Approximately 20,000 households at each site will be visited by study staff and consent sought from the he
Sponsors
University of Oxford
International Centre for Diarhoea and Diarrhoeal Research, Bangladesh
Unviersity of Liverpool
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Census study, WASH and HUS survey: Census participants will be the population (n =100,000, all ages) residing in a demarcated geographic area that is a known catchment population for each of the 3 typhoid surveillance sites. Participants will be recruited and consented as households. 1. Head of household / key informant is willing and competent to give informed consent for participation of the household in the study 2. Head of household / key informant is Male or Female, aged 18 years or above 3. Household is within the census area Passive surveillance: This component will include all patients presenting at any of the clinical surveillance sites in each country with a history of subjective fever >72 hours with or without objective fever on presentation. 1. Individual willing and competent to give informed consent if =18 years or the parent/legal guardian if participant 14 years) will be randomly selected from the census population. 1. Individual willing and competent to give informed consent if =18 years or the parent/legal guardian if participant <18 years 2. Male or female 3. Able to comply with study requirements 4. Resident in census area Household contacts (of suspected chronic carriers identified in serosurvey): Individuals resident in 50 households of suspected chronic carriers will be approached to request blood and stool samples in order to assess risk of infection in this group. 1. Resident in the same household as suspected chronic carrier identified in the serosurvey; 2. Individual willing and competent to give informed consent if =18 years or the parent/legal guardian if participant <18 years; 3. Able to comply with study requirements.
Exclusion criteria
Exclusion criteria: Census study, WASH and HUS survey: 1. Head of household/key informant not willing for household to participate 2. Unable to identify Head of household/key informant Passive surveillance: 1. Previous enrolment into this component (e.g. from previous attendance at healthcare facility with persistent fever) 2. Other underlying disease which can be rapidly diagnosed such as Malaria in children (Blantyre) Household contacts (index cases): 1. Not a resident of household of index case at time of his/her primary illness 2. Fever at presentation in index case confirmed not due to S. Typhi or Paratyphi fever 3. Deemed clinically unsuitable by the survey team (e.g. terminally ill) Serosurveillance: 1. Not resident in the census area 2. Deemed clinically unsuitable by the survey team (e.g. terminally ill) Household contacts (of suspected chronic carriers identified in serosurvey): 1. Not a resident of household of suspected chronic carrier at time of the visit 2. Deemed clinically unsuitable by the survey team (e.g. terminally ill)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The burden of enteric fever (typhoid and paratyphoid) in Africa and Asia, within the census populations, over a 2-year observation period, as determined by: 1. The number of new cases confirmed by blood culture 2. The rate of carriage per 1000 head of population 3. The infection rate amongst household contacts of confirmed cases | — |
Secondary
| Measure | Time frame |
|---|---|
| Antibody detection rates per 1000 head of population during the 2-year observation period to determine: 1. Rate of chronic carriage 2. Incidence of non-clinical typhoid 3. Rates of infection arising from close contact with confirmed enteric fever and chronic carriers | — |
Countries
Bangladesh, Malawi, Nepal
Contacts
Public ContactSarah Kelly
Outcome results
None listed