Evaluation of Moore and grab sampling method for Salmonella Typhi detection in environmental samples in Ghana

Michael Owusu, Eric Darko, Debora Akortia, Gifty Nkrumah, Sampson Twumasi-Ankrah, Michael Owusu-Ansah, Christopher B Uzzell, Jonathan Rigby, Catherine M Troman, Nicolette A Zhou, John Scott Meschke, Alexander G Shaw, Nicholas C Grassly, Yaw Adu-Sarkodie and Ellis Owusu-Dabo

PLOS ONE, 2025, vol. 20, issue 2, 1-16

Abstract: Background: Typhoid fever causes substantial mortality and morbidity in low and middle-income countries (LMICs) as a result of inadequate water, hygiene, and sanitation facilities. The gold standard for typhoid diagnosis is blood culture, however this method is expensive and mostly unavailable in LMICs. Environmental surveillance (ES) could offer a low cost alternative to identify circulation of Salmonella enterica serovar Typhi (S.Typhi) and help inform public health interventions including vaccination. Methods: We implemented standardized protocols for ES at 40 validated sites in peri-urban communities in Ghana from July 2022 to August 2023. Grab samples (GS) and Moore swabs (MS) were collected monthly for the initial 6 months and subsequently monthly MS were maintained for the rest of the study period. Wastewater samples were tested for S. Typhi target genes (ttr, staG, tviB) and a biomarker of human faecal contamination (Bacteroides HF183) using multiplex quantitative PCR (qPCR). Clinical surveillance for typhoid fever was performed by blood culture of febrile cases presenting to the local hospital who lived in the study area. Results: For the first 6 months of wastewater ES, we observed a higher prevalence of S. Typhi in MS compared to GS [100/240 (42%; 95% Confidence Interval [CI]: 34-50% vs. 24/240 (10%; 95% CI: 6-16%)]; p-value

Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0318840

DOI: 10.1371/journal.pone.0318840

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