Trends in typhoid fever during the COVID-19 pandemic in Pakistan

Introduction: Pakistan has been experiencing an extensively drug-resistant (XDR) outbreak of typhoid for some years. We sought to evaluate how the COVID-19 pandemic impacted typhoid epidemiology in Pakistan, from the beginning of the pandemic in 2020 through the end of 2022, and the reduction of CO...

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Main Authors: Carly Ching, Muhammad H Zaman, Azra Parveen, Faisal Sultan, Summiya Nizamuddin
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2024-04-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/18374
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author Carly Ching
Muhammad H Zaman
Azra Parveen
Faisal Sultan
Summiya Nizamuddin
author_facet Carly Ching
Muhammad H Zaman
Azra Parveen
Faisal Sultan
Summiya Nizamuddin
author_sort Carly Ching
collection DOAJ
description Introduction: Pakistan has been experiencing an extensively drug-resistant (XDR) outbreak of typhoid for some years. We sought to evaluate how the COVID-19 pandemic impacted typhoid epidemiology in Pakistan, from the beginning of the pandemic in 2020 through the end of 2022, and the reduction of COVID-19 cases. Methodology: We compared national public COVID-19 data with retrospectively obtained patient data of confirmed S. Typhi isolates between January 2019 and December 2022 from Shaukat Khanum Memorial Cancer Hospital and Research Centre and the hospital’s extended network of laboratory collection centers across Pakistan. Results: We observed that during the early onset of the COVID-19 pandemic and COVID-19 peaks, typhoid positivity generally decreased. This suggests that restrictions and non-pharmaceutical interventions that limited social interactions and promoted good sanitation and hygiene practices had a positive secondary effect on typhoid. This led to an overall yearly decrease in typhoid positivity between 2019 to 2021. However, the percentage of S. Typhi cases isolated that were ceftriaxone-resistant continued to increase, suggesting the continued dominance of XDR typhoid in Pakistan. In 2022, with the alleviation of pandemic restrictions, we observed increased typhoid positivity and COVID-19 and typhoid positivity started to follow similar trends. Conclusions: Given the continued presence of COVID-19 along with XDR typhoid in Pakistan, it will be imperative to use differential testing to ensure that the epidemiology of each reported is accurate, the spread of each it contained, and that antibiotics are not misused. The use of approved vaccinations will lessen the burden of both diseases.
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publisher The Journal of Infection in Developing Countries
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spelling doaj-art-8626f83fbd8a4591bf0c34a1d5fab6742025-08-20T02:27:22ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802024-04-01180410.3855/jidc.18374Trends in typhoid fever during the COVID-19 pandemic in PakistanCarly Ching0Muhammad H Zaman1Azra Parveen2Faisal Sultan3Summiya Nizamuddin4Department of Biomedical Engineering, Boston University, Boston, MA, United StatesDepartment of Biomedical Engineering, Boston University, Boston, MA, United StatesShaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PakistanShaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PakistanShaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan Introduction: Pakistan has been experiencing an extensively drug-resistant (XDR) outbreak of typhoid for some years. We sought to evaluate how the COVID-19 pandemic impacted typhoid epidemiology in Pakistan, from the beginning of the pandemic in 2020 through the end of 2022, and the reduction of COVID-19 cases. Methodology: We compared national public COVID-19 data with retrospectively obtained patient data of confirmed S. Typhi isolates between January 2019 and December 2022 from Shaukat Khanum Memorial Cancer Hospital and Research Centre and the hospital’s extended network of laboratory collection centers across Pakistan. Results: We observed that during the early onset of the COVID-19 pandemic and COVID-19 peaks, typhoid positivity generally decreased. This suggests that restrictions and non-pharmaceutical interventions that limited social interactions and promoted good sanitation and hygiene practices had a positive secondary effect on typhoid. This led to an overall yearly decrease in typhoid positivity between 2019 to 2021. However, the percentage of S. Typhi cases isolated that were ceftriaxone-resistant continued to increase, suggesting the continued dominance of XDR typhoid in Pakistan. In 2022, with the alleviation of pandemic restrictions, we observed increased typhoid positivity and COVID-19 and typhoid positivity started to follow similar trends. Conclusions: Given the continued presence of COVID-19 along with XDR typhoid in Pakistan, it will be imperative to use differential testing to ensure that the epidemiology of each reported is accurate, the spread of each it contained, and that antibiotics are not misused. The use of approved vaccinations will lessen the burden of both diseases. https://jidc.org/index.php/journal/article/view/18374COVID-19typhoiddrug resistance
spellingShingle Carly Ching
Muhammad H Zaman
Azra Parveen
Faisal Sultan
Summiya Nizamuddin
Trends in typhoid fever during the COVID-19 pandemic in Pakistan
Journal of Infection in Developing Countries
COVID-19
typhoid
drug resistance
title Trends in typhoid fever during the COVID-19 pandemic in Pakistan
title_full Trends in typhoid fever during the COVID-19 pandemic in Pakistan
title_fullStr Trends in typhoid fever during the COVID-19 pandemic in Pakistan
title_full_unstemmed Trends in typhoid fever during the COVID-19 pandemic in Pakistan
title_short Trends in typhoid fever during the COVID-19 pandemic in Pakistan
title_sort trends in typhoid fever during the covid 19 pandemic in pakistan
topic COVID-19
typhoid
drug resistance
url https://jidc.org/index.php/journal/article/view/18374
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AT azraparveen trendsintyphoidfeverduringthecovid19pandemicinpakistan
AT faisalsultan trendsintyphoidfeverduringthecovid19pandemicinpakistan
AT summiyanizamuddin trendsintyphoidfeverduringthecovid19pandemicinpakistan