Multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya
Background: Understanding the dynamics of infection and carriage of typhoid in endemic settings is critical to finding solutions to prevention and control. Methods: In a 3-year case-control study, we investigated typhoid among children aged <16 years (4670 febrile cases and 8549 age matched c...
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eLife Sciences Publications Ltd
2021
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oai:doaj.org-article:87e1ad6489f44d1985757fb13d9b6c622021-11-15T06:04:03ZMultiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya10.7554/eLife.678522050-084Xe67852https://doaj.org/article/87e1ad6489f44d1985757fb13d9b6c622021-09-01T00:00:00Zhttps://elifesciences.org/articles/67852https://doaj.org/toc/2050-084XBackground: Understanding the dynamics of infection and carriage of typhoid in endemic settings is critical to finding solutions to prevention and control. Methods: In a 3-year case-control study, we investigated typhoid among children aged <16 years (4670 febrile cases and 8549 age matched controls) living in an informal settlement, Nairobi, Kenya. Results: 148 S. Typhi isolates from cases and 95 from controls (stool culture) were identified; a carriage frequency of 1 %. Whole-genome sequencing showed 97% of cases and 88% of controls were genotype 4.3.1 (Haplotype 58), with the majority of each (76% and 88%) being multidrug-resistant strains in three sublineages of the H58 genotype (East Africa 1 (EA1), EA2, and EA3), with sequences from cases and carriers intermingled. Conclusions: The high rate of multidrug-resistant H58 S. Typhi, and the close phylogenetic relationships between cases and controls, provides evidence for the role of carriers as a reservoir for the community spread of typhoid in this setting. Funding: National Institutes of Health (R01AI099525); Wellcome Trust (106158/Z/14/Z); European Commission (TyphiNET No 845681); National Institute for Health Research (NIHR); Bill and Melinda Gates Foundation (OPP1175797).Samuel KariukiZoe A DysonCecilia MbaeRonald NgetichSusan M KavaiCelestine WairimuStephen AnyonaNaomi GitauRobert Sanaya OnsareBeatrice OngandiSebastian DucheneMohamed AliJohn David ClemensKathryn E HoltGordon DouganeLife Sciences Publications Ltdarticletyphoidchildrencarriagemultidrug-resistantH58 lineagesKenyaMedicineRScienceQBiology (General)QH301-705.5ENeLife, Vol 10 (2021) |
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typhoid children carriage multidrug-resistant H58 lineages Kenya Medicine R Science Q Biology (General) QH301-705.5 |
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typhoid children carriage multidrug-resistant H58 lineages Kenya Medicine R Science Q Biology (General) QH301-705.5 Samuel Kariuki Zoe A Dyson Cecilia Mbae Ronald Ngetich Susan M Kavai Celestine Wairimu Stephen Anyona Naomi Gitau Robert Sanaya Onsare Beatrice Ongandi Sebastian Duchene Mohamed Ali John David Clemens Kathryn E Holt Gordon Dougan Multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya |
| description |
Background: Understanding the dynamics of infection and carriage of typhoid in endemic settings is critical to finding solutions to prevention and control.
Methods: In a 3-year case-control study, we investigated typhoid among children aged <16 years (4670 febrile cases and 8549 age matched controls) living in an informal settlement, Nairobi, Kenya.
Results: 148 S. Typhi isolates from cases and 95 from controls (stool culture) were identified; a carriage frequency of 1 %. Whole-genome sequencing showed 97% of cases and 88% of controls were genotype 4.3.1 (Haplotype 58), with the majority of each (76% and 88%) being multidrug-resistant strains in three sublineages of the H58 genotype (East Africa 1 (EA1), EA2, and EA3), with sequences from cases and carriers intermingled.
Conclusions: The high rate of multidrug-resistant H58 S. Typhi, and the close phylogenetic relationships between cases and controls, provides evidence for the role of carriers as a reservoir for the community spread of typhoid in this setting.
Funding: National Institutes of Health (R01AI099525); Wellcome Trust (106158/Z/14/Z); European Commission (TyphiNET No 845681); National Institute for Health Research (NIHR); Bill and Melinda Gates Foundation (OPP1175797). |
| format |
article |
| author |
Samuel Kariuki Zoe A Dyson Cecilia Mbae Ronald Ngetich Susan M Kavai Celestine Wairimu Stephen Anyona Naomi Gitau Robert Sanaya Onsare Beatrice Ongandi Sebastian Duchene Mohamed Ali John David Clemens Kathryn E Holt Gordon Dougan |
| author_facet |
Samuel Kariuki Zoe A Dyson Cecilia Mbae Ronald Ngetich Susan M Kavai Celestine Wairimu Stephen Anyona Naomi Gitau Robert Sanaya Onsare Beatrice Ongandi Sebastian Duchene Mohamed Ali John David Clemens Kathryn E Holt Gordon Dougan |
| author_sort |
Samuel Kariuki |
| title |
Multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya |
| title_short |
Multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya |
| title_full |
Multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya |
| title_fullStr |
Multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya |
| title_full_unstemmed |
Multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya |
| title_sort |
multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, kenya |
| publisher |
eLife Sciences Publications Ltd |
| publishDate |
2021 |
| url |
https://doaj.org/article/87e1ad6489f44d1985757fb13d9b6c62 |
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