Understanding the burden of enteric fever in Africa and Asia: A study of transmission and antibiotic resistance to improve diagnostics and inform vaccine strategies

{Typhoid Fever Research  (Cohort) Study (STRATAA)}

The Oxford University (United Kingdom), the Oxford University Clinical Research Unit (Nepal), the Patan Academy of Health Sciences (Patan Hospital) and the Nepal Family Development Foundation are jointly conducting a typhoid fever research study (STRATAA) in this sub-metropolitan city. This study aims to find out how many people suffer from typhoid in this community, sources and transmission routes, the effectiveness of currently used drugs and drug resistance. We will enroll 1 lakh participants from approximately 20,000 households in Lalitpur sub-metropolitan from where the Patan Hospital receives a large number of patients.

The first phase is a census and we will visit all households in the above mentioned wards to collect data.

We will be conducting this typhoid surveillance for 2 years. In addition to surveillance, there are other phases in this study which include WASH and Health care utilization survey, Sero-survey, Passive Surveillance and Index case tracking. We will also be trying to find out why some people remain healthy and do not show any symptoms of illness even when bacteria that cause typhoid have been found in their blood. We will also be asking participants, where they sought medical services (point of first contact) when they became ill.

Findings of this research study will be a help to the Nepal Government for the necessary changes needed in health services and disease control, as well as in plans for vaccination programs. Participation of people from Lalitpur sub metropolitan city in this study is important. Nepal Family Development Foundation, the Lalitpur Sub-metropolitan City Public Health Section, Ward Offices and the Ward Health Implementation Committee are jointly working in this surveillance program.