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,typhoid fever poses a serious disease burden in the country. In fact, in West Bengal, there were 235,013 cases in 2017, contributing 10.58% to India’s total burden.
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 more than one sixth of respondents in Kolkata who did not vaccinate their children (17%) 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. Monjori Mitra, Associate Professor of Institute of Child Health, Kolkata said, “The Indian subcontinent has the highest incidence of typhoid worldwide. The illness is characterized by prolonged fever, headache, nausea, loss of appetite, and constipation or 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 prevention all the more important. The findings of this survey indicate that physician recommendation can play a key role in ensuring higher immunization rates to protect children from this disease, as can efforts to educate patients. Though in current situation at least in the metro cities the mortality is less. But in todays context the morbidity is also of great concern and moreover the economical burden for treatment, wages loss for the sick child at home and hospitalization cost would always be more than the vaccine cost. So it would be very important for an awareness drive.”
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. Significantly, less than half of mothers from Kolkata identified close contact (35%), touching contaminated surfaces (19%) or eating food cooked by a typhoid patient (29%) 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 14% of the respondents in Kolkata stated that they prefer to take the risk of getting a serious medical condition than to receive a vaccination for it.
Dr. Monjori Mitra added, “Prevention through vaccination will help reduce typhoid burden, morbidity 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 survey findings indicate the vast majority of mothers have low levels of awareness about typhoid and the specific precautions that need to be taken to protect themselves and their families. Educating mothers about the benefits of getting their child vaccinated is the need of the hour.”
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.”