Table 3

Incidence estimates of MDR iNTS disease in sub-Saharan Africa

Country*Age group in yearsPYO estimation†Recruitment proportion†Genome-sequenced iNTS casesCrude MDR iNTS casesCrude MDR iNTS incidence per 100 000 PYOAdjusted MDR iNTS casesAdjusted MDR iNTS incidence per 100 000 PYO
(95% CI)‡
Proportion of catchment population visiting study facility in case of fever (95% CI)Catchment populationCatchment population adjusted by health-seeking behaviourPYO
Burkina Faso
 Nioko II0–181% (74 to 88)220817882097247/1297 (19)21485251 (107 to 590)
2–481% (75 to 86)182314772097235/1259 (19)3314316753 (460 to 1233)
5–1481% (78 to 84)429534794889228/889 (26)2120479 (29 to 214)
<15n.a.832667449083n.a.755525274 (185 to 406)
≥1581% (79 to 83)9428763710 676208/759 (27)119435 (13 to 96)
Alln.a.17 75414 38119 759n.a.863029145 (100 to 209)
 Polesgo0–192% (86 to 99)896824929117/475 (25)111084431 (162 to 1147)
2–483% (76 to 89)856710992148/466 (32)222026630 (288 to 1380)
5–1487% (83 to 91)173415092104252/510 (49)00000
<15n.a.348630434025n.a.337510255 (138 to 470)
≥1587% (84 to 89)408835574917239/629 (38)1120354 (16 to 179)
Alln.a.757466008942n.a.444513144 (83 to 249)
Ghana§
 AAN0–116% (14 to 18)11 22217604080418824588591435 (1110 to 1854)
2–416% (13 to 18)8086126829404123930622747 (491 to 1135)
0–4n.a.n.a.n.a.n.a.n.a.11133n.a.n.a.n.a.
5–1416% (15 to 17)34 439541512 554623/1657 (38)664816126 (77 to 206)
<15n.a.53 747844319 574n.a.1173914781414 (333 to 515)
≥15n.a.n.a.n.a.n.a.n.a.1610n.a.n.a.n.a.
All_TSAPn.a.n.a.n.a.n.a.n.a.13349n.a.n.a.n.a.
Non_TSAP¶n.a.n.a.n.a.n.a.n.a.4939n.a.n.a.n.a.
Alln.a.n.a.n.a.n.an.a.18288n.a.n.a.n.a.
Guinea-Bissau
 Bandim0–146% (39 to 54)10 85249925198206/631 (33)729615291 (176 to 482)
2–443% (37 to 48)730731423866175/359 (49)1026253 (13 to 208)
5–1442% (41 to 48)19 905836011 101187/380 (49)1018437 (14 to 97)
<15n.a.38 06416 49420 165n.a.924021105 (69 to 161)
≥1545% (43 to 47)62 69428 21237 109105/163 (64%)00000
Alln.a.100 75844 70657 274n.a.92142137 (24 to 57)
Kenya
 Kibera0–142% (38 to 47)34671456203199/99 (100)00000
2–439% (36 to 43)307011972039312/312 (100)00000
5–1443% (39 to 47)751432315722539/539 (100)00000
<15n.a.14 05158849792n.a.00000
≥1535% (32 to 38)15 26353429228301/301 (100)1111111 (2 to 77)
Alln.a.29 31411 22719 020n.a.11515 (1 to 37)
Senegal**
 Pikine0–139% (32 to 46)20 120783711 194n.a.00n.a.n.a.n.a.
2–437% (33 to 41)30 18011 09715 851n.a.11n.a.n.a.n.a.
5–1431% (28 to 34)96 15229 80742 577n.a.00n.a.n.a.n.a.
<15n.a.146 45248 74169 623n.a.11n.a.n.a.n.a.
≥1530% (28 to 31)195 72658 71883 874n.a.10n.a.n.a.n.a.
Alln.a.342 178107 459153 496n.a.21n.a.n.a.n.a.
  • *TSAP was performed in 10 countries, of which 8 countries (Burkina Faso, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa and Tanzania in alphabetical order) exhibited positive iNTS isolates confirmed via whole genome sequencing. MDR iNTS were found in 5/8 countries presented in this table. No MDR iNTS were detected via whole genome sequencing from the isolates yielded from Madagascar, South Africa and Tanzania.

  • †PYO estimation methodologies have been published in detail in the TSAP typhoid burden paper (Marks et al, Lancet Global Health, 2017).

  • ‡Adjusted MDR iNTS incidence per 100 000 PYO (95% CI): adjustments for case recruitment and error factors.

  • §Ghana samples included in this estimation of MDR iNTS are from the TSAP only.

  • ¶Non-TSAP includes other fever surveillance performed in Agogo (‘IsolateAgogo’, ‘FISA’ and ‘zTYSA’). Refer to the Methods section.

  • **Adjusted MDR incidence of iNTS per 100 000 PYO could not be estimated for the study site in Senegal due to unavailable data on the recruitment proportion. The one MDR iNTS patient confirmed and presented in this table (crude MDR iNTS case) was a male infant aged 17 months, infected in 2012 with S. Enteritidis ST11. The one non-MDR iNTS patient presented in this table (genome-sequenced iNTS case) was a male adult aged 66 years, infected in 2012 with S. Typhimurium.

  • n.a., not available; PYO, person-years-of-observation.