National strategies and challenges in the fight against typhoid fever and other invasive salmonellosis in Kenya: the urgency to act

Salmonellosis and typhoid fever are public health challenges in Kenya causing a significant mortality rate, especially among vulnerable children. Typhoid fever is endemic in Kenya, with an estimated 126 000 cases occurring annually. In most places, the case-fatality rate is as high as 10-20% and outbreaks occur sporadically across different regions. This study aims to provide an overview of the epidemiology of typhoid fever and invasive salmonellosis, the current national strategies in place and challenges in their implementation in Kenya. A narrative review of existing literature and recent epidemiological data was conducted, focusing on Kenya-specific studies, public health reports, and global disease surveillance sources. Available data shows that the epidemiology of typhoid fever is influenced by various factors, including population density, socio-economic status, environmental conditions, and lack of vaccine coverage. Kenya’s national strategies to combat typhoid fever and invasive salmonellosis include vaccination with the Typhoid Conjugate Vaccine (TCV), improving water and sanitation infrastructure, and antimicrobial resistance control, but implementation gaps and resource constraints continue to limit their overall effectiveness. Expanding short term TCV vaccination campaigns, community engagement, improving water and sanitation infrastructure, enforcing antimicrobial regulation, and strengthening capacity for effective monitoring are imperative for reducing disease burden, and protecting the health of the most at-risk communities.