Geospatial estimation of typhoid incidence in India

Authors: Yanjia Cao*, University of California - San Diego, Nathan Lo, University of California, San Francisco, Jason Andrews, Stanford University, Jacob John, Christian Medical College, Gagandeep Kang, Christian Medical College, Arun Karthikeyan, Christian Medical College, Swathi Krishna, Christian Medical College, Reshma Raju, Christian Medical College, Chella Sindhu, Christian Medical College, Manikandan Srinivasan, Christian Medical College, Tess Ryckman, Stanford University
Topics: Medical and Health Geography, Asia
Keywords: typhoid fever, spatial prediction, cohort and surveillance data, India
Session Type: Virtual Paper
Day: 4/10/2021
Start / End Time: 8:00 AM / 9:15 AM
Room: Virtual 8
Presentation File: No File Uploaded


Typhoid has hit the world hard as an enteric fever, with infection of Salmonella Typhi or Paratyphi. In 2017 there were more than 14 million cases globally, with a vast majority in low and middle-income countries. Among these places, India has the highest reported incidence of typhoid fever, with up to 25% infected population. However, there has been limited control on typhoid in India because of low perception in disease burden in this country. Our research has two prior studies over a two year observation period: 1) One cohort study based on four sties including 6,000 children ages 6 months to 15 years; and 2) One hybrid study based on six surveillance sites including persons ages 6 months and older. The spatial prediction of typhoid fever will be based on incidence rates at known locations and various factors that are associated with typhoid fever. We collected 9 covariates (i.e., physical and social variables) from demographic and health surveys (DHS) at household level. The spatial prediction model was implemented at 5*5km grid level for the entire country. We estimated a national incidence of typhoid fever in India of 361 cases per 100,000 person-years, with an annual estimate of 4.5 million cases and 11,200 deaths. We found substantial geographic variation of typhoid incidence across the country, with higher incidence in southern states and central urban centers. The result is of significance to the India government to understand the geospatial burden of typhoid fever and to generate surveillance strategy in high-risk location

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