Nationwide survey of 1,337 respondents across eight cities shows low awareness on typhoid prevalence and ways to prevent it including vaccination
About one third (31%) of respondents in Mumbai who did not vaccinate their children considered typhoid to be ‘not at all serious’ or ‘mild/easily manageable’
With 2.2 million cases of typhoid recorded in India in 2016, the country has one of the highest incidence rates in the world, with the disease affecting mainly children
MUMBAI, India, 21 July 2020 — Abbott, one of India’s leading healthcare companies, partnered with Babygogo (part of the Sheroes Network), to conduct a nationwide survey across eight cities* to assess awareness around typhoid fever. With 2.2 million cases of typhoid being recorded in India alone in 2016,1 typhoid fever poses a serious disease burden in the country. In fact, in Maharashtra alone, there were 77,997 cases in 2017, contributing 3.51% to India’s total burden.2
Typhoid fever, which is a bacterial infection, tends to affect children most, with peak incidence occurring in children aged 5-15 years.3 Currently available evidence shows that vaccination against typhoid is effective and tolerable.4 The survey results highlighted that only 66% of respondents reported being aware of a typhoid vaccination.
Key Survey Findings
There are higher levels of awareness for mandatory vaccines, i.e., vaccines given in National Immunization Program of the country (NIP) such as rotavirus (82%) compared to vaccines not given in NIP such as influenza (67%) and typhoid (66%).
The survey revealed that about one third of respondents in Mumbai who did not vaccinate their children (31%) considered typhoid to be ‘not at all serious’ or ‘mild/easily manageable’, unaware of the fact that the bacterial infection can lead to serious complications if left untreated or treated with inappropriate medicines.
Other findings suggest that key reasons for not vaccinating include absence of vaccine recommendation by the pediatrician (48%) and non-inclusion in the list of NIP vaccines (36%).
Misleading Symptoms and Delay in Treatment
Commenting on these findings, Dr. Vijay Yewale, a leading pediatrician in Mumbai said, “The Indian subcontinent has the highest incidence of typhoid worldwide.5 The illness is characterized by prolonged fever, headache, nausea, loss of appetite, constipation and sometimes diarrhoea6. Since these symptoms are often clinically non-distinguishable from other illnesses causing fever, typhoid is frequently not treated appropriately at the early stages when such treatment is most effective – which makes early preventive measures, such as good hygiene and vaccination all the more important. The survey findings indicate that physician recommendation and efforts to educate can play a key role in ensuring higher immunization rates to protect children from this disease.”
Myths on Causes for the Disease
Survey findings also show that myths about the disease are highly prevalent. As a bacterial bloodstream infection, typhoid fever spreads through contaminated water and food, often due to lack of hygiene and access to drinkable water. Yet 57% of survey respondents nationwide inaccurately attributed the cause of typhoid to a change of weather or season. Only a minority of caregivers in Mumbai identified close contact (24%), touching contaminated surfaces (22%) or eating food cooked by a typhoid patient (21%) as risky behaviours that could spread typhoid.
Prevention Helps Lessen Infections and Drug Resistance
Studies have shown that vaccinations can help lower the incidence of infection, but 13% of the respondents in Mumbai stated that they prefer to take the risk of getting a serious medical condition than to receive a vaccination for it.
Dr. Yewale added, “Prevention through vaccination will help reduce the typhoid burden and mortality. Given the rising emergence of drug-resistant strains of typhoid, administration of typhoid vaccination to populations at high risk of infection is a public health priority. 7 The findings indicate that the vast majority of people surveyed have low levels of awareness about typhoid and the specific precautions that need to be taken to protect themselves and their families. Education around the benefits of getting children vaccinated is required.”
Dr. Srirupa Das, Medical Director, Abbott India, explains, “The findings shed light on awareness levels, motivation and behaviors around typhoid vaccination in India. They suggest that increased awareness on typhoid and ways to prevent it, such as improved hygiene levels and vaccination, can contribute to lessening India’s health burden due to typhoid infections. As part of our mission of helping people live healthier lives, we support educational initiatives on typhoid fever in India, especially amongst new mothers and parents in general.”
3 Typhoid vaccines: WHO position paper. World Health Organization. Week Epidemiol Rec. 2018;13(93):153-72. March 2018.
4 Typhoid vaccines: WHO position paper. World Health Organization. Week Epidemiol Rec. 2018;13(93):153-72. March 2018.
7 Typhoid vaccines: WHO position paper. World Health Organization. Week Epidemiol Rec. 2018;13(93):153-72. March 2018.
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