Estimating typhoid incidence from community-based serosurveys: a multicohort study.
Estimating typhoid incidence from community-based serosurveys: a multicohort study.
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DOI：
10.1016/s2666-5247(22)00114-8
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发表时间：
2022-08
期刊：
影响因子：
38.2
通讯作者：
Andrews, Jason R.
中科院分区：
文献类型：
--
作者：
Aiemjoy, Kristen;Seidman, Jessica C.;Saha, Senjuti;Munira, Sira Jam;Sajib, Mohammad Saiful Islam;Al Sium, Syed Muktadir;Sarkar, Anik;Alam, Nusrat;Zahan, Farha Nusrat;Kabir, Md Shakiul;Tamrakar, Dipesh;Vaidya, Krista;Shrestha, Rajeev;Shakya, Jivan;Katuwal, Nishan;Shrestha, Sony;Yousafzai, Mohammad Tahir;Iqbal, Junaid;Dehraj, Irum Fatima;Ladak, Yasmin;Maria, Noshi;Adnan, Mehreen;Pervaiz, Sadaf;Carter, Alice S.;Longley, Ashley T.;Fraser, Clare;Ryan, Edward T.;Nodoushani, Ariana;Fasano, Alessio;Leonard, Maureen M.;Kenyon, Victoria;Bogoch, Isaac I.;Jeon, Hyon Jin;Haselbeck, Andrea;Park, Se Eun;Zellweger, Raphael M.;Marks, Florian;Owusu-Dabo, Ellis;Adu-Sarkodie, Yaw;Owusu, Michael;Teunis, Peter;Luby, Stephen P.;Garrett, Denise O.;Qamar, Farah Naz;Saha, Samir K.;Charles, Richelle C.;Andrews, Jason R.
伤寒沙门氏菌（伤寒和副伤寒沙门氏菌血清型）引起的侵袭性细菌感染-肠热病的发病率在没有血培养监测的地区基本上是未知的。本研究的目的是评估新的伤寒沙门氏菌诊断血清学标记物是否可以可靠地估计人群水平的发病率。我们从2016年至2021年期间在孟加拉国，尼泊尔，巴基斯坦和加纳的监测研究中招募的血培养证实的肠热病患者中收集了纵向血液样本，并在每个监测点的集水区进行了横断面血清调查。我们使用ELISA来测量定量伊加和IgG抗体反应溶血素E和S伤寒脂多糖。我们使用贝叶斯分层模型拟合两阶段幂函数衰减模型的纵向抗体反应之间的肠热病病例和使用的联合分布的峰值抗体滴度和衰减率，估计人口水平的发病率从横断面血清调查。所有抗原同种型的纵向抗体动力学在各国之间相似，并且不因临床严重程度而变化。5岁以下儿童中伤寒沙门氏菌感染的血清发生率范围为孟加拉国达卡的58.5/100人-年（95%CI 42.1 - 81.4）至尼泊尔Kavrepalanchok的6.6/100人-年（4.3 - 9.9），并遵循与临床发病率估计值相同的等级顺序。这里描述的方法有可能扩大伤寒沙门氏菌监测的地理范围，并产生跨地理区域和时间可比的发病率估计。比尔和梅林达·盖茨基金会。摘要的尼泊尔语、孟加拉语和乌尔都语翻译见补充材料部分。
The incidence of enteric fever, an invasive bacterial infection caused by typhoidal Salmonellae (Salmonella enterica serovars Typhi and Paratyphi), is largely unknown in regions without blood culture surveillance. The aim of this study was to evaluate whether new diagnostic serological markers for typhoidal Salmonella can reliably estimate population-level incidence. We collected longitudinal blood samples from patients with blood culture-confirmed enteric fever enrolled from surveillance studies in Bangladesh, Nepal, Pakistan, and Ghana between 2016 and 2021 and conducted cross-sectional serosurveys in the catchment areas of each surveillance site. We used ELISAs to measure quantitative IgA and IgG antibody responses to hemolysin E and S Typhi lipopolysaccharide. We used Bayesian hierarchical models to fit two-phase power-function decay models to the longitudinal antibody responses among enteric fever cases and used the joint distributions of the peak antibody titres and decay rate to estimate population-level incidence rates from cross-sectional serosurveys. The longitudinal antibody kinetics for all antigen-isotypes were similar across countries and did not vary by clinical severity. The seroincidence of typhoidal Salmonella infection among children younger than 5 years ranged between 58·5 per 100 person-years (95% CI 42·1–81·4) in Dhaka, Bangladesh, to 6·6 per 100 person-years (4·3–9·9) in Kavrepalanchok, Nepal, and followed the same rank order as clinical incidence estimates. The approach described here has the potential to expand the geographical scope of typhoidal Salmonella surveillance and generate incidence estimates that are comparable across geographical regions and time. Bill & Melinda Gates Foundation. For the Nepali, Bengali and Urdu translations of the abstract see Supplementary Materials section.