High burden of typhoid disease in sub-Saharan Africa calls for urgent roll-out of typhoid conjugate vaccines

By 2019, there were an estimated 9·24 million cases of typhoid fever and 110 000 deaths globally, with the greatest burden being in low-income and middle-income countries in sub-Saharan Africa and Asia1 where poor sanitation and a lack of safe drinking water, the primary modes of transmission, are common.2 If not treated promptly, complications such as intestinal perforation or neurological problems can arise with severe sequelae.3 Diagnosis of typhoid is difficult in low-resource settings due to limited adequate laboratory infrastructure, and clinical presentation can be non-specific and inconclusive.