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Volume 32, Number 8—August 2026
Research
Use of Salmonella enterica Serovar Typhi Hemolysin E and Lipopolysaccharide IgA to Identify Enteric Fever Cases, South Asia
Jessica C. Seidman1
, Kristen Aiemjoy1, Mehreen Adnan, Irum Fatima Dehraj, Junaid Iqbal, Khalid Iqbal, Seema Irfan, Nahidul Islam, Md. Shakiul Kabir, Nishan Katuwal, Noshi Maria, Muhammad Ashraf Memon, Sira Jam Munira, Shiva Ram Naga, Sailesh Pradhan, Anik Sarkar, Rajeev Shrestha, Sony Shrestha, Syed Muktadir Al Sium, Krista Vaidya, Douglas Ezra Morrison, Alice S. Carter, Senjuti Saha, Dipesh Tamrakar, Mohammad Tahir Yousafzai, Denise O. Garrett, Stephen P. Luby, Farah Naz Qamar, Samir Saha, Jason R. Andrews, and Richelle C. Charles
, Kristen Aiemjoy1, Mehreen Adnan, Irum Fatima Dehraj, Junaid Iqbal, Khalid Iqbal, Seema Irfan, Nahidul Islam, Md. Shakiul Kabir, Nishan Katuwal, Noshi Maria, Muhammad Ashraf Memon, Sira Jam Munira, Shiva Ram Naga, Sailesh Pradhan, Anik Sarkar, Rajeev Shrestha, Sony Shrestha, Syed Muktadir Al Sium, Krista Vaidya, Douglas Ezra Morrison, Alice S. Carter, Senjuti Saha, Dipesh Tamrakar, Mohammad Tahir Yousafzai, Denise O. Garrett, Stephen P. Luby, Farah Naz Qamar, Samir Saha, Jason R. Andrews, and Richelle C. Charles
Table
Characteristics of laboratory-confirmed enteric fever cases and alternative etiology controls in study of the use of Salmonella Typhi hemolysin E and lipopolysaccharide IgA to identify enteric fever cases, South Asia*
| Characteristic | Bangladesh |
Nepal |
Pakistan |
All |
p value | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Case, n = 411 | Control, n = 79 | Case, n = 155 | Control, n = 102 | Case, n = 84 | Control, n = 82 | Case, n = 650 | Control, n = 263 | |||||
| Age | ||||||||||||
| Median |
5.4 |
3.0 |
19.4 |
28.0 |
9.0 |
29.5 |
7.0 |
22.0 |
<0.001 |
|||
| IQR, Q1–Q3 |
3.3–8.0 |
1.0–7.0 |
14.9–25.7 |
19.5–38.0 |
4.0–17.0 |
17.0–39.8 |
4.0–13.0 |
4.5–34.0 |
||||
| Age category, y, no. (%) | ||||||||||||
| <5 | 180 (43.8) | 50 (63.3) | 4 (2.6) | 7 (6.9) | 24 (28.6) | 9 (11.0) | 208 (32.0) | 66 (25.1) | <0.001 | |||
| 5–15 | 230 (56.0) | 28 (35.4) | 39 (25.2) | 13 (12.7) | 36 (42.9) | 10 (12.2) | 305 (46.9) | 51 (19.4) | ||||
| >16 |
1 (0.2) |
1 (1.3) |
112 (72.3) |
82 (80.4) |
24 (28.6) |
63 (76.8) |
137 (21.1) |
146 (55.5) |
||||
| Sex, no. (%) | ||||||||||||
| M | 214 (52.1) | 45 (57.0) | 95 (61.3) | 54 (52.9) | 48 (57.1) | 69 (84.1) | 357 (54.9) | 168 (63.9) | 0.0162 | |||
| F |
197 (47.9) |
34 (43.0) |
60 (38.7) |
48 (47.1) |
36 (42.9) |
13 (15.9) |
293 (45.1) |
95 (36.1) |
||||
| Days of fever at presentation | ||||||||||||
| Median | 4.0 | 3.0 | 4.0 | 3.0 | 6.0 | 5.0 | 4.0 | 4.0 | 0.15 | |||
| IQR, Q1–Q3 |
3.0–6.0 |
2.0–4.0 |
3.0–5.0 |
3.0–6.0 |
4.8–8.0 |
4.0–7.0 |
3.0–6.0 |
3.0–6.0 |
||||
| HlyE IgA concentration | ||||||||||||
| Median | 27.6 | 2.1 | 19.2 | 4.7 | 36.5 | 3.0 | 26.4 | 3.4 | <0.001 | |||
| IQR, Q1–Q3 |
10.4–57.3 |
0.8–5.5 |
5.9–50.0 |
2.6–8.1 |
15.9–102.3 |
1.5–5.0 |
9.5–59.1 |
1.6–6.3 |
||||
| LPS IgA concentration | ||||||||||||
| Median | 82.3 | 2.3 | 106.1 | 4.5 | 162.6 | 6.6 | 98.0 | 4.5 | <0.001 | |||
| IQR, Q1–Q3 | 31.9–158.9 | 0.5–5.6 | 32.6–223.8 | 3.1–9.8 | 73.5–321.0 | 3.6–10.9 | 35.3–190.2 | 2.2–9.4 | ||||
*p values estimated for the comparisons between all cases and controls. IQR, interquartile range; Q, quarter.
1These authors contributed equally to this article.
Page created: June 12, 2026
Page updated: July 10, 2026
Page reviewed: July 10, 2026
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