Seroincidence Rate of Typhoidal Salmonella in Children, Kenya, 2017–2018

TL;DR

The study found higher rates of typhoidal Salmonella infection in coastal Kenyan children compared to western Kenya, highlighting the need for better public health measures.

Contribution

The novel use of IgG responses to hemolysin E provided new insights into typhoidal Salmonella seroincidence in Kenyan communities.

Findings

Enteric fever seroincidence was 37/100 person-years in coastal Kenya versus 3.6/100 in western Kenya.

Higher seroincidence was linked to nonpiped water, lower income, and higher population density.

The findings highlight a critical need for typhoid conjugate vaccine introduction in Kenya.

Abstract

Enteric fever, caused by Salmonella enterica serovars Typhi and Paratyphi, results in high rates of illness and death globally. The lack of reliable diagnostic assays limits surveillance, leading to major gaps in understanding the population-level burden in low- and middle-income countries. We applied a novel serologic tool measuring IgG responses to hemolysin E to assess typhoidal Salmonella infection rates in children from 4 communities: 2 in western Kenya (Kisumu and Chulaimbo) and 2 in coastal Kenya (Ukunda and Msambweni). We found a substantially higher enteric fever seroincidence rate in coastal Kenya (37/100 person-years) than in western Kenya (3.6/100 person-years). We found a higher seroincidence rate in households with nonpiped water and lower incomes and in neighborhoods with higher population density. Our findings contribute to Kenya's limited enteric fever surveillance data, especially in the coastal regions. Such information underscores the need for public health interventions, such as typhoid conjugate vaccine introduction, in Kenya.

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