Children under 10 bear biggest burden of typhoid in India: Study

A recent study has highlighted the significant impact of typhoid fever on India’s economy, with antibiotic-resistant infections emerging as a major contributor. The findings underline not only the health risks but also the heavy financial strain faced by families across the country.

Resistance accounts for majority of costs

According to research published in The Lancet Regional Health Southeast Asia, antibiotic-resistant typhoid infections were responsible for at least 87 percent of the country’s disease-related economic burden in 2023.

The overall economic cost of typhoid fever in India was estimated to be Rs 123 billion, indicating the scale of the issue.

Children bear the greatest impact

The study found that children below the age of 10 accounted for more than half of the total economic burden. Researchers, including experts from the London School of Hygiene and Tropical Medicine and Christian Medical College, noted that this age group remains particularly vulnerable.

Households face heavy financial strain

A large portion of the financial burden falls directly on families. The analysis showed that households covered 91 percent of the expenses related to treatment. Around 70,000 families experienced what researchers described as “catastrophic” health expenditure.

Certain states contributed significantly to the national cost. Maharashtra, Uttar Pradesh, Andhra Pradesh including Telangana, Tamil Nadu, and West Bengal together accounted for 51 per cent of the overall economic burden.

Understanding typhoid fever

Typhoid fever is a bacterial infection typically spread through contaminated food and water. Common symptoms include high fever, fatigue, headaches, and abdominal pain.

Implications for vaccination and policy

The authors of the study stated that the findings offer strong evidence in support of introducing the typhoid conjugate vaccine into India’s national immunisation programme, which is currently under consideration.

They also highlighted the need to strengthen measures to control antibiotic resistance and to use the findings to guide national health financing strategies.

How the study was conducted

Researchers used empirical data from across India, examining patterns in typhoid infection, healthcare-seeking behaviour, clinical outcomes, and both direct and indirect treatment costs. The analysis covered patients who were hospitalised as well as those treated outside hospitals.

The authors observed that typhoid fever places a substantial economic burden on the country. This burden is shaped by fluoroquinolone resistance, a higher impact on children under ten, and the concentration of cases in high-burden states, all of which contribute to significant financial pressure on households.

Role of antibiotic resistance

The study found that infections resistant to fluoroquinolone antibiotics alone accounted for 87 per cent of the total costs. Fluoroquinolone is commonly used to treat severe infections and is known for its effectiveness in reducing fever in typhoid patients within four days.

The researchers also pointed out that existing data on the economic impact of typhoid has been limited and fragmented. This study, however, provides a more comprehensive and nationally representative estimate.

A call for urgent action

The analysis concluded that fluoroquinolone-resistant typhoid infections are a key driver of the disease’s economic burden in India. These infections disproportionately affect young children and place a heavy financial load on families, highlighting the urgent need for improved prevention, treatment, and policy interventions.

With agency inputs