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Volume 31, Number 10—October 2025

Research

Comparative Epidemiology of Salmonella enterica Serovers Paratyphi A and Typhi Causing Enteric Fever, Bangladesh, 2018–2020

Sadia Isfat Ara Rahman1Comments to Author , Md Golam Firoj1, Se Eun Park1, Farhana Khanam1, Suneth Agampodi1, Kassa Haile1, Edilawit Mesfin, Faisal Ahmmed, Md Taufiqul Islam, Ashraful Islam Khan, Fahima Chowdhury, Afroza Akter, Martin Bundi Mwebia, Justin Im, Natasha Y. Rickett, Cecilia Kathure Mbae, Asma Binte Aziz, Beatrice Ongadi, Moses Mwangi, Benjamin Ngugi, Meseret Gebre Behute, Kelvin Kering, Suman Kanungo, Xinxue Liu, Deok Ryun Kim, Andrew J. Pollard, K Zaman2, Samuel Kariuki2, Firdausi Qadri2, and John D. Clemens2
Author affiliation: icddr,b, Dhaka, Bangladesh (S.I.A. Rahman, M.G. Firoj, F. Khanam, F. Ahmmed, M.T. Islam, A.I. Khan, F. Chowdhury, A. Akter, K. Zaman, F. Qadri, J.D. Clemens); Yonsei University Graduate School of Public Health, Seoul, South Korea (S.E. Park); International Vaccine Institute, Seoul (S.E. Park, S. Agampodi, N.Y. Rickett, A.B. Aziz, M.G. Behute, D.R. Kim, J.D. Clemens); Armauer Hansen Research Institute, Addis Ababa, Ethiopia (K. Haile, E. Mesfin); Kenya Medical Research Institute, Nairobi, Kenya (M.B. Mwebia, C.K. Mbae, B. Ongadi, M. Mwangi, B. Ngugi, K. Kering, S. Kariuki); RIGHT Foundation, Seoul (J. Im); ICMR, National Institute of Cholera and Enteric Diseases, Kolkata, India (S. Kanungo); University of Oxford, Oxford, UK (X. Liu, A.J. Pollard); NIHR Oxford Biomedical Research Centre and Oxford University Hospitals NHS Foundation Trust, Oxford (A.J. Pollard); UCLA Fielding School of Public Health, Los Angeles, California, USA (J.D. Clemens); Korea University Vaccine Innovation Center, Seoul (J.D. Clemens)

Main Article

Table 5

Clinical findings of Salmonella Paratyphi A and Salmonella Typhi by age group from cases detected in the dynamic cohort in epidemiologic study, Bangladesh, 2018–2020*

Clinical finding Paratyphoid cases from all clusters, n = 121 Typhoid cases from JE clusters, n = 483 p value
Overall 121 (100) 483 (100)
Mean body temperature, °C (±SD) 37.8 (±0.95) 37.9 (±0.93) 0.165†
High fever, ≥40°C 2 (1.7) 3 (0.6) 0.263‡
Antibiotic taken in past 2 weeks 35 (28.9) 109 (22.6) 0.177
Admitted to hospital 5 (4.1) 24 (5.0) 0.883
Median duration of hospitalization, d (IQR) 6 (5–6) 9.5 (5–13) 0.139§
Gastrointestinal tract diseases¶ 29 (24.0) 147 (30.4) 0.198
Lower respiratory tract diseases# 33 (27.3) 130 (26.9) >0.999
Upper respiratory tract diseases** 12 (9.9) 67 (13.9) 0.316
Neurologic diseases‡‡ 13 (10.7) 39 (8.1) 0.450
Rash/new lesion
 1 (0.8)
 3 (0.6)
 >0.999‡
<5 years of age 22 (18.2) 189 (39.1)
Mean body temperature, °C (±SD) 37.8 (±1.04) 37.9 (±0.92) 0.677†
High fever, ≥40°C 2 (9.1) 0 (0.0) 0.010‡
Antibiotic taken in past 2 weeks 8 (36.4) 39 (20.6) 0.159
Admitted to hospital 1 (4.5) 8 (4.2) >0.999‡
Median duration of hospitalization, d (IQR) 4 (4–4) 10.5 (10–13) 0.241§
Gastrointestinal tract diseases¶ 4 (18.2) 59 (31.2) 0.324‡
Lower respiratory tract diseases# 8 (36.4) 59 (31.2) 0.803
Upper respiratory tract diseases** 5 (22.7) 33 (17.5) 0.753
Neurologic diseases‡‡ 1 (4.5) 5 (2.6) 0.488‡
Rash/new lesion
 0 (0.0)
 0 (0.0)
 >0.999‡
>5 years of age 99 (81.8) 294 (60.9)
Mean body temperature, °C (±SD) 37.8 (±0.93) 37.9 (±0.95) 0.221†
High fever (≥40°C) 0 (0.0) 3 (1.0) 0.575‡
Antibiotic taken in last 2 weeks 27 (27.3) 70 (23.8) 0.578
Admitted to hospital 4 (4.0) 16 (5.4) 0.792‡
Median duration of hospitalization, d (IQR) 6 (6–6) 8 (5–13) 0.669§
Gastrointestinal tract diseases¶ 25 (25.3) 88 (29.9) 0.446
Lower respiratory tract diseases# 25 (25.3) 71 (24.1) 0.932
Upper respiratory tract diseases** 7 (7.1) 34 (11.6) 0.282
Neurologic diseases‡‡ 12 (12.1) 34 (11.6) >0.999
Rash/new lesion 1 (1.0) 3 (1.0) >0.999‡

*Values are no. (%) except as indicated. p values derived from χ2 test except as indicated. †By t-test for mean difference. ‡By Fisher exact test. §By Mann-Whitney U test. ¶Gastrointestinal includes any of the following: abdominal pain, nausea, vomiting, diarrhea. #Lower respiratory tract includes any of the following: cough, wheeze, tachypnea, respiratory distress. **Upper respiratory tract includes any of the following: sore throat, coryza, ear pain, enlarged tonsils, painful/swollen lymph nodes in head/neck, stridor. ‡‡Neurological includes any of the following: headache, photophobia, neck stiffness, seizure.

Main Article

1These first authors contributed equally to this article.

2Thes authors contributed as joint senior authors.

Page created: August 12, 2025
Page updated: September 25, 2025
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