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dc.contributor.authorKariuki, Samuel
dc.contributor.authorDyson, Zoe A
dc.contributor.authorMbae, Cecilia
dc.contributor.authorNgetich, Ronald
dc.contributor.authorKavai, Susan M
dc.contributor.authorWairimu, Celestine
dc.contributor.authorAnyona, Stephen
dc.contributor.authorGitau, Naomi
dc.contributor.authorOnsare, Robert Sanaya
dc.contributor.authorOngandi, Beatrice
dc.contributor.authorDuchene, Sebastian
dc.contributor.authorAli, Mohamed
dc.contributor.authorClemens, John David
dc.contributor.authorHolt, Kathryn E
dc.contributor.authorDougan, Gordon
dc.date.accessioned2021-10-08T23:30:52Z
dc.date.available2021-10-08T23:30:52Z
dc.date.issued2021-09-13
dc.identifier.issn2050-084X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/329176
dc.description.abstractBackground: Understanding the dynamics of infection and carriage of typhoid in endemic settings is critical to finding solutions to prevention and control. Methods: In a 3 year case-control study, we investigated typhoid among children aged <16 years (4,670 febrile cases and 8,549 age matched controls) living in an informal settlement, Nairobi, Kenya. Results: 148 S. Typhi isolates from cases and 95 from controls (stool culture) were identified; a carriage frequency of 1%. Whole-genome sequencing showed 97% of cases and 88% of controls were genotype 4.3.1 (Haplotype 58), with the majority of each (76% and 88%) being multidrug-resistant strains in 3 sublineages of H58 genotype (East Africa 1 (EA1), EA2, and EA3), with sequences from cases and carriers intermingled. Conclusions: The high rate of multidrug-resistant H58 S.Typhi, and the close phylogenetic relationships between cases and controls, provides evidence for the role of carriers as a reservoir for the community spread of typhoid in this setting. Funding: National Institutes of Health (R01AI099525); Wellcome Trust (106158/Z/14/Z); European Commission (TyphiNET No 845681); National Institute for Health Research (NIHR); Bill and Melinda Gates Foundation (OPP1175797).
dc.languageeng
dc.publishereLife Sciences Publications Ltd
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectS. enterica serovar typhi
dc.subjectepidemiology
dc.subjectglobal health
dc.subjectinfectious disease
dc.subjectmicrobiology
dc.titleMultiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya.
dc.typeArticle
prism.number10:e67852
prism.publicationNameeLife
dc.identifier.doi10.17863/CAM.76624
dcterms.dateAccepted2021-09-08
rioxxterms.versionofrecord10.7554/eLife.67852
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2021-09-08
dc.contributor.orcidDougan, Gordon [0000-0003-0022-965X]
dc.identifier.eissn2050-084X
rioxxterms.typeJournal Article/Review
pubs.funder-project-idWellcome Trust (106158/Z/14/Z)
cam.issuedOnline2021-09-13


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International