Infection and Drug Resistance (May 2022)
Typhoid in Pakistan: Challenges, Efforts, and Recommendations
Abstract
Zoaib Habib Tharwani,1 Prince Kumar,1 Yumna Salman,1 Zarmina Islam,1 Shoaib Ahmad,2 Mohammad Yasir Essar3 1Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan; 2District Head Quarters Teaching Hospital, Faisalabad, Pakistan; 3Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Mohammad Yasir Essar, Email [email protected]: Typhoid, and its extra drug resistant form which is highly prevalent Pakistan, is increasing the burden on healthcare through multiple factors. These range from lack of sanitation, the collapsing economy, and poor access to clean drinking water which have made it arduous for the government and various other organizations in containing it. With the COVID-19 pandemic, treatment of typhoid became a challenge as focus was driven towards limiting the COVID-19 spread, and hence preferential use of antibiotics such as azithromycin may limit future empirical antibiotic therapy for typhoid. Socioeconomic disparities and geographical as well as demographic barriers further limit access to appropriate typhoid management. Lastly, illiteracy and self-medication with antibiotics may predispose Pakistan to another outbreak of typhoid. These concerns, although largely unaddressed effectively, need immediate action. Previously, the government and international organizations have made efforts to control the spread through the introduction of TCV as a part of EPI and awareness, additional improvements are needed. These include: improving access to telemedicine in rural areas, extensive vaccination programs, and routine awareness programs especially in schools.Keywords: typhoid, COVID-19, water sanitation, healthcare, vaccine, Pakistan
