Journal Article

Case Fatality Rate of Enteric Fever in Endemic Countries: A Systematic Review and Meta-analysis

Bilcke, Joke, Antillón, Marina, Saad, Neil J, Pieters, Zoë, Pitzer, Virginia E

2018

Overview

We conducted a systematic literature review and meta-analysis and estimated the case fatality rate of enteric fever to be 2.49% (95% confidence interval, 1.65%-3.75%; n = 44), 2.5 times higher than what was assumed up until now. Abstract Enteric fever is a febrile illness, occurring mostly in Asia and Africa, which can present as a severe and possibly fatal disease. Currently, a case fatality rate (CFR) of 1% is assumed when evaluating the global burden of enteric fever. Until now, no meta-analysis has been conducted to summarize mortality from enteric fever. Therefore, we conducted a systematic review and meta-analysis to aggregate all available evidence. We estimated an overall CFR of 2.49% (95% confidence interval, 1.65%-3.75%; n = 44), and a CFR in hospitalized patients of 4.45% (2.85%-6.88%; n = 21 of 44). There was considerably heterogeneity in estimates of the CFR from individual studies. Neither age nor antimicrobial resistance were significant prognostic factors, but limited data were available for these analyses. The combined estimate of the CFR for enteric fever is higher than previously estimated, and the evaluation of prognostic factors, including antimicrobial resistance, urgently requires more data.

• Publisher: Oxford University Press
• Subject: Africa - epidemiology / Anti-Bacterial Agents - pharmacology / Asia - epidemiology / Endemic Diseases / Humans / Paratyphoid Fever - mortality / Review / Salmonella paratyphi A - drug effects / Salmonella paratyphi A - isolation & purification / Salmonella typhi - drug effects / Salmonella typhi - isolation & purification / Typhoid Fever - mortality