Insights and References for Healthcare Professionals
This resource section compiles key typhoid studies and reports from authoritative sources, explore evidence-based data on symptomatology, treatment algorithms, preventative strategies, and vaccination efficacy.
The Indian Journal of Medical Research
Typhoid Fever: Control & Challenges in India
Enteric fever is a critical public health challenge in India, particularly affecting children. Controlling typhoid requires integrated strategies that combine diagnostics, surveillance, vaccination, and WASH initiatives.
The Indian Journal of Medical Research
A Systematic Review of Antimicrobial Resistance of Typhoidal Salmonella in India
Analysis of antimicrobial resistance (AMR) trends in typhoid fever from 1992 to 2017 in India. The findings highlight the need for updated treatment guidelines and vaccine strategies to counter resistant strains.
Centers for Disease Control and Prevention
Clinical Guidance for Typhoid Fever and Paratyphoid Fever
A comprehensive overview of typhoid, detailing clinical features, severe complications, diagnosis, prevention and treatment.
New England Journal of Medicine
Burden of Typhoid and Paratyphoid Fever in India
A study in India using active surveillance found higher typhoid rates in urban areas, challenging assumptions about the disease. Findings highlight the need for targeted vaccination and better surveillance.
Indian Academy of Pediatrics
IAP Standard Treatment Guidelines 2022
Outline of typhoid fever management, including recognising age-specific symptoms, prioritising blood culture over serological tests, followed by treatment with antibiotic regimens with dosage guidelines for children.
Mayo Clinic
Typhoid Fever - Diagnosis & Treatment
A guideline for typhoid fever diagnosis via clinical evaluation, travel history and lab tests, along with recommended treatments for different types of antibiotics.
World Health Organization
Summary of Key Characteristics of WHO Prequalified Typhoid Conjugate Vaccines (TCVs)
Comparison of two WHO-prequalified typhoid conjugate vaccines, highlighting their composition, efficacy and safety. Out of the two, Typbar-TCV has shown proven field effectiveness.
BMC Infectious Diseases
Associations of Water, Sanitation, and Hygiene with Typhoid Fever in Case–Control Studies: A Systematic Review and Meta-Analysis
A review of 27 case-control studies confirmed that improved water, sanitation and hygiene (WASH) practices reduce the odds of contracting typhoid. Simple, low-cost solutions like water treatment, hygiene education and better infrastructure can effectively prevent typhoid in areas with limited resources.
Open Forum Infectious Diseases
Typhoid Control in an Era of Antimicrobial Resistance: Challenges and Opportunities
Rising AMR in S. typhi makes it imperative to focus on prevention and not rely on antibiotics. Sustainable control measures are possible with typhoid conjugate vaccines and WASH improvements. Prioritising prevention is the key to breaking the cycle of resistance.
Jaypee Brothers
Purple Book: IAP Guidebook on Immunization 2022 By Advisory Committee on Vaccines and Immunization Practices (ACVIP)
(Pages 285 – 320) A detailed review of typhoid vaccines in India, emphasising the shift from older vaccines to newer typhoid conjugate vaccines for their superior efficacy, longer immunity and suitability for children.
New England Journal of Medicine
Phase 3 Efficacy Analysis of a Typhoid Conjugate Vaccine Trial in Nepal
A randomized trial in Nepal found that a single dose of Typbar TCV was ~82% efficacious in preventing blood culture-confirmed typhoid fever in children (9 months–16 years). The vaccine was immunogenic and provided significant protection even in the youngest children.
The Lancet
Protection by Vaccination of Children Against Typhoid Fever with a Vi-tetanus Toxoid Conjugate Vaccine in Urban Bangladesh: A Cluster-Randomised Trial
A study in Bangladesh involving >61,000 children (9 months–<16 years) showed ~85% protection against typhoid over two years. The vaccine was highly effective across all age groups, including ~81% in toddlers under 2 years old. No serious adverse events were observed.
The Lancet
5-Year Vaccine Protection Following a Single Dose of Vi-tetanus Toxoid Conjugate Vaccine in Bangladeshi Children (TyVOID): A Cluster Randomised Trial
A five-year follow-up study in Bangladesh found that Typbar TCV’s effectiveness declined to ~50% by years 3–5, suggesting a potential need for a booster dose around school entry age.
The Lancet
Efficacy of Typhoid Conjugate Vaccine: Final Analysis of a 4-Year, Phase 3, Randomised Controlled Trial in Malawian Children
A placebo-controlled trial in Malawi (~28,000 children, 9 months–12 years) found Typbar TCV ~78% efficacious over four years, with robust protection across all age groups and minimal decline in effectiveness.
Indian Journal of Medical Research
Azithromycin Resistance Mechanisms in Typhoidal Salmonellae in India: A 25 Years Analysis
A study of 602 archived isolates found that azithromycin remains effective against typhoidal Salmonella in India, but increasing resistance trends were observed. No acquired resistance genes were detected, highlighting the need for continuous antimicrobial surveillance.
American Journal of Tropical Medicine and Hygiene
Field Effectiveness of a Typhoid Conjugate Vaccine: The 2018 Navi Mumbai Pediatric TCV Campaign
A large-scale vaccination campaign targeting ~113,000 children (9 months–14 years) demonstrated ~84% field effectiveness of Typbar TCV.
Clinical Infectious Diseases
Spontaneous Emergence of Azithromycin Resistance in Independent Lineages of Salmonella Typhi in Northern India
A study analyzing 66 Salmonella Typhi isolates from Chandigarh, India, identified seven strains with a specific mutation (R717Q in the acrB gene) conferring azithromycin resistance.
The Lancet Global Health
Effectiveness of Typhoid Conjugate Vaccine Against Culture-Confirmed Salmonella Enterica Serotype Typhi in an Extensively Drug-Resistant Outbreak Setting of Hyderabad, Pakistan: A Cohort Study
During an extensively drug-resistant (XDR) typhoid outbreak in Hyderabad, Pakistan, Typbar TCV showed 95% effectiveness against culture-confirmed typhoid and 97% against XDR typhoid strains in a cohort of ~23,000 children.
Human Vaccines & Immunotherapeutics
Co-Administration of Typbar TCV with Routine Childhood Vaccines
A clinical trial in India (493 infants) found Typbar TCV could be safely given alongside measles/MMR vaccines at 9 months, with no impact on immune responses.
Vaccine
Typhoid Conjugate Vaccine Implementation in India: A Review of Supportive Evidence
A comprehensive review of Typbar TCV’s cost-effectiveness, safety, and efficacy in India, highlighting gaps in long-term protection data.
Vaccine
Effectiveness of Typhoid Conjugate Vaccine in Zimbabwe Used in Response to an Outbreak Among Children and Young Adults: A Matched Case Control Study
A 2019 study in Zimbabwe evaluated the effectiveness of the Typhoid Conjugate Vaccines during outbreaks. Results showed strong protection, especially in children (75–84% effectiveness), reinforcing TCV’s role in controlling typhoid.
Journal of Infection
Blood Culture-PCR to Optimise Typhoid Fever Diagnosis After Controlled Human Infection Identifies Frequent Asymptomatic Cases and Evidence of Primary Bacteraemia
A culture-PCR assay detects S. Typhi DNA in blood, offering diagnostic insights but lower sensitivity than blood culture. It identifies asymptomatic infections and early bacteraemia post-ingestion, but its applicability in clinical settings is limited.
Frontiers in Bacteriology
Enteric Fever and the Diagnostic Tools: Defining the Accuracy
This study evaluated Typhipoint EIA (ELISA) against blood clot PCR, finding 92.9% sensitivity and 68.8% specificity. Enhancing rapid test accuracy may improve diagnostic reliability and reduce unnecessary antimicrobial use in resource-limited settings.
Frontiers in Bacteriology
Enteric Fever Diagnosis: Current Challenges and Future Directions
Current diagnostic methods, including culture, PCR, and serology, have limitations. Research focuses on identifying biomarkers for improved detection, emphasising cost-effective, accessible diagnostics for endemic regions.
Disclaimer: The content on this page is meant for Indian healthcare professionals only. Patients should consult their doctors for medical advice.