Multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya
- Kariuki, Samuel
- Dyson, Zoe A
- Mbae, Cecilia
- Ngetich, Ronald
- Kavai, Susan M
- Wairimu, Celestine
- Anyona, Stephen
- Gitau, Naomi
- Onsare, Robert Sanaya
- Ongandi, Beatrice
- Duchene, Sebastian
- Ali, Mohamed
- Clemens, John David
- Holt, Kathryn E
- Dougan, Gordon
DOIAbstract
Background:: 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 (4670 febrile cases and 8549 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 three sublineages of the H58 genotype (East Africa 1 (EA1), EA2, and EA3), with sequences fro...
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