The Coalition against Typhoid (CaT), an initiative of the Sabin Vaccine Institute, brought together leading paediatricians from across Asia to discuss the hyper-endemic burden of typhoid in the region and offer solutions to combat this growing epidemic. It called on policy makers and ministries of health across Asia to make typhoid vaccination a priority in their countries at the 14th Asia Pacific Congress of Paediatrics.
“Paediatric associations and others across the region recognise typhoid’s serious impact, particularly the rising and widespread threat of drug resistant typhoid. Many–including India and Indonesia–have made recommendations supporting the use of typhoid vaccines,” said Dr Zulfiqar A Bhutta, Founding Chair, Women and Child Health Division, The Aga Khan University, Karachi, Pakistan. “National stakeholders and policy makers should review the evidence and discuss the adoption of typhoid vaccines.”
Despite the World Health Organization’s (WHO) recommendation to prioritise typhoid vaccines for “immediate” implementation at a 2009 WHO meeting, many countries in Asia are yet to recommend or introduce typhoid vaccines.
“Since 1997, the Vietnamese Ministry of Health has used typhoid vaccination to effectively control disease in high risk districts,” said Dr Nguyen Van Cuong, Deputy Head of Vietnam’s National Immunization Program. “Successful programmes have also been implemented in China and Thailand.”
According to the WHO, typhoid impacts an estimated 21 million people and causes more than 200,000 deaths annually, predominantly among preschool and school-age children in developing countries of Asia and Africa. WHO reports that 90 per cent of typhoid deaths occur in Asia.
“WHO approved typhoid vaccines are available now, yet these tools are not yet fully embraced by ministries of health across Asia,” said Dr Christopher Nelson, Director of the Coalition against Typhoid Secretariat at Sabin. “Paediatric associations and other stakeholders should review the evidence and discuss the implementation of typhoid vaccines.”
Typhoid is widespread in poverty-stricken communities without access to safe water and basic sanitation and spreads through contaminated water and food. In addition to the high number of deaths, typhoid infection impacts school attendance and achievement and limits workforce participation and productivity.
“In Bangladesh, typhoid is a leading cause of hospital admission among children, adolescents, and young adults with fever-like symptoms,” said Dr Mesbah Uddin Ahmed, Immediate past Secretary General Bangladesh Paediatric Association (BPA), Secretary of the Immunization Sub Committee BPA, and Head of the Dept of Child Health, Gonosasthyo Samaj Vittick Medical College, Savar, Dhaka.
In their discussions and presentations, these paediatricians emphasised the need for improved surveillance and control programmes throughout the region, noting that in order to have the greatest impact, typhoid vaccination efforts must be implemented in conjunction with other public health programmes, such as access to safe drinking water and the promotion of good hygiene practices, including hand washing.
EH News Bureau