The STRATAA study protocol: a programme to assess the burden of enteric fever in Bangladesh, Malawi and Nepal using prospective population census, passive surveillance, serological studies and healthcare utilisation surveys

作者：Thomas C. Darton, James Meiring, Susan Tonks, Arifuzzaman Khan, Farhana Khanam, Mila Shakya, Deus Thindwa, Stephen G. Baker, Buddha Basnyat, John David Clemens, Gordon Dougan, Christiane Dolecek, Sarah J. Dunstan, Melita A. Gordon, Robert S. Heyderman, Kathryn E. Holt, Virginia E. Pitzer, Firdausi Qadri, Khalequ Zaman, Andrew John Pollard · 发表于：BMJ Open · 年份：2017 · DOI：10.1136/bmjopen-2017-016283 · 被引用次数：78 · 研究领域：Salmonella and Campylobacter epidemiology、Viral gastroenteritis research and epidemiology、Escherichia coli research studies

Introduction Invasive infections caused by Salmonella enterica serovar Typhi and Paratyphi A are estimated to account for 12–27 million febrile illness episodes worldwide annually. Determining the true burden of typhoidal Salmonellae infections is hindered by lack of population-based studies and adequate laboratory diagnostics. The Strategic Typhoid alliance across Africa and Asia study takes a systematic approach to measuring the age-stratified burden of clinical and subclinical disease caused by typhoidal Salmonellae infections at three high-incidence urban sites in Africa and Asia. We aim to explore the natural history of Salmonella transmission in endemic settings, addressing key uncertainties relating to the epidemiology of enteric fever identified through mathematical models, and enabling optimisation of vaccine strategies. Methods/design Using census-defined denominator populations of ≥100 000 individuals at sites in Malawi, Bangladesh and Nepal, the primary outcome is to characterise the burden of enteric fever in these populations over a 24-month period. During passive surveillance, clinical and household data, and laboratory samples will be collected from febrile individuals. In parallel, healthcare utilisation and water, sanitation and hygiene surveys will be performed to characterise healthcare-seeking behaviour and assess potential routes of transmission. The rates of both undiagnosed and subclinical exposure to typhoidal Salmonellae (seroincidence), identificati...