%0 Journal Article
%T Assessing the Impact of Drug Resistance on the Transmission Dynamics of Typhoid Fever
%A S. Mushayabasa
%A C. P. Bhunu
%A E. T. Ngarakana-Gwasira
%J Computational Biology Journal
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/303645
%X Typhoid fever continues to be a major public health problem in the developing world. Antibiotic therapy has been the main stay of treating typhoid fever for decades. The emergence of drug-resistant typhoid strain in the last two decades has been a major problem in tackling this scourge. A mathematical model for investigating the impact of drug resistance on the transmission dynamics of typhoid fever is developed. The reproductive number for the model has been computed. Numerical results in this study suggest that when a typhoid outbreak occurs with more drug-sensitive cases than drug-resistant cases, then it may take 10每15 months for symptomatic drug-resistant cases to outnumber all typhoid cases, and it may take an average of 15每20 months for nonsymptomatic drug-resistant cases to outnumber all drug-sensitive cases. 1. Introduction Typhoid fever is caused by Salmonella enterica serovar Typhi (S. Typhi), a gram-negative bacterium [1每3]. It continues to be a global public health problem with over 21.6 million cases and at least 250,000 deaths occurring annually [4每6]. Almost 80% of the cases and deaths are in Asia; the rest occur mainly in Africa and Latin America [3, 7]. In developing countries such as India, the disease occurs with an incidence ranging from 102 to 2,219 per 100,000 of the population [3, 8]. Several studies in areas of endemicity and outbreaks have shown that about one-quarter to one-third of pediatric typhoid fever cases are under five years of age, and that between 6% and 21% are under two years of age [9]. Varied presentations of typhoid fever are known in the pediatric age group, such as septicemia in neonates, as diarrhoea in infants, and as lower respiratory tract infections in older children [10每12]. Typical presentation in older children includes splenic abscess, liver abscess, cerebellar ataxia, meningitis, cholecystitis, chorea, palatal palsy, osteomyelitis, peritonitis, aphasia, and even psychosis [13每16]. Due to these varied and typical presentations, it is common for typhoid fever in children to be diagnosed late or even remain unrecognised. Also, no vaccine against typhoid fever is available commercially for children under two years of age [14]. To complicate matters further, in the last two decades, multidrug-resistant (MDR) S. Typhi strains have emerged and spread worldwide, resulting in high rates of morbidity and mortality [14, 15, 17]. Typhoid drug resistance emerged first in the UK within 2 years of the successful use of chloramphenicol on typhoid treatment [18, 19]. Subsequently, isolates carrying transferable
%U http://www.hindawi.com/journals/cbj/2013/303645/