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Antibiotic resistance behind 87% of typhoid economic burden: Lancet

Lancet estimates the total economic burden due to typhoid fever at Rs 12,300 crore.

Kavita Bajeli-Datt

NEW DELHI: Antibiotic-resistant typhoid infections accounted for at least 87% of India’s disease-related economic burden in 2023, says a new study published in The Lancet Regional Health Southeast Asia. It estimates the total economic burden due to typhoid fever at Rs 12,300 crore.

The researchers, including those from London School of Hygiene and Tropical Medicine and Christian Medical College in Vellore, said children under the age of 10 incurred the highest economic burden, contributing to over half of the costs.

Maharashtra, Uttar Pradesh, Andhra Pradesh, Telangana, Tamil Nadu and West Bengal are estimated to account for 51% of the national costs.

The researchers also estimated that households bore 91% of expenses, and 70,000 families faced “catastrophic” health expenditure. Typhoid fever, an infectious disease, is commonly transmitted through contaminated food or water. The symptoms include high fever, fatigue, headache and stomach pain.

The researchers said the findings provide key evidence to support the introduction of the typhoid conjugate vaccine in the national immunisation schedule, which is under consideration. Evidence from the study also supports enhancing antibiotic resistance control and guiding national health financing policies.

The researchers analysed empirical data from India on typhoid epidemiology, care-seeking, clinical outcomes, and estimated direct and indirect costs for hospitalised and non-hospitalised typhoid fever patients. “Typhoid fever imposes a significant economic burden in India, shaped by fluoroquinolone resistance, children less than 10 years of age, and high-burden provincial states of the country, resulting in considerable household financial strain,” the authors noted.

Fluoroquinolone-resistant infections accounted for 87% of total costs. The antibiotic fluoroquinolone helps treat severe infections and is said to be highly effective in reducing fever in typhoid within four days. Available evidence on the economic burden of typhoid fever is fragmented and geographically limited, they pointed out.

The study presents a, nationally representative estimate. The analysis also indicated that fluoroquinolone-resistant infections drive the economic burden of typhoid fever in India, disproportionately affecting young children and placing a financial burden on families.

Rs 12K-cr cost

  1. Total economic burden due to typhoid at `12,300 cr

  2. Children under the age of 10 incur the highest economic burden

  3. Households bear 91% of expenses and 70,000 families faced severe health expenditure

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