{"doi":"10.7554/elife.67852","title":"Multiple introductions of multidrug-resistant typhoid associated with acute infection and asymptomatic carriage, Kenya","abstract":"Background: Understanding the dynamics of infection and carriage of typhoid in endemic settings is critical to finding solutions to prevention and control. Methods: In a 3-year case-control study, we investigated typhoid among children aged <16 years (4670 febrile cases and 8549 age matched controls) living in an informal settlement, Nairobi, Kenya. Results: . Typhi isolates from cases and 95 from controls (stool culture) were identified; a carriage frequency of 1 %. Whole-genome sequencing showed 97% of cases and 88% of controls were genotype 4.3.1 (Haplotype 58), with the majority of each (76% and 88%) being multidrug-resistant strains in three sublineages of the H58 genotype (East Africa 1 (EA1), EA2, and EA3), with sequences from cases and carriers intermingled. Conclusions: . Typhi, and the close phylogenetic relationships between cases and controls, provides evidence for the role of carriers as a reservoir for the community spread of typhoid in this setting. Funding: National Institutes of Health (R01AI099525); Wellcome Trust (106158/Z/14/Z); European Commission (TyphiNET No 845681); National Institute for Health Research (NIHR); Bill and Melinda Gates Foundation (OPP1175797).","journal":"eLife","year":2021,"id":156327,"datarank":0.6038027536102726,"base_score":4.02535169073515,"endowment":4.02535169073515,"self_citation_contribution":0.6038027536102726,"citation_network_contribution":0.0,"self_endowment_contribution":0.6038027536102726,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":55,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8523,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":660591,"name":"Zoe A. Dyson","orcid":"0000-0002-8887-3492","position":1,"is_corresponding":false},{"id":345188,"name":"Cecilia Mbae","orcid":"0000-0002-6933-248X","position":2,"is_corresponding":false},{"id":346536,"name":"Ronald Ngetich","orcid":null,"position":3,"is_corresponding":false},{"id":345190,"name":"Susan Kavai","orcid":"0000-0003-4617-9985","position":4,"is_corresponding":false},{"id":346535,"name":"Celestine Wairimu","orcid":null,"position":5,"is_corresponding":false},{"id":661214,"name":"Stephen Anyona","orcid":null,"position":6,"is_corresponding":false},{"id":457975,"name":"Naomi Gitau","orcid":null,"position":7,"is_corresponding":false},{"id":346534,"name":"Robert Onsaŕe","orcid":null,"position":8,"is_corresponding":false},{"id":661215,"name":"Beatrice Ongandi","orcid":null,"position":9,"is_corresponding":false},{"id":256369,"name":"Sebastián Duchêne","orcid":"0000-0002-2863-0907","position":10,"is_corresponding":false},{"id":533681,"name":"Mohamed Ali","orcid":"0000-0003-4105-776X","position":11,"is_corresponding":false},{"id":345191,"name":"John D. Clemens","orcid":"0000-0002-6379-1052","position":12,"is_corresponding":false},{"id":1684,"name":"Kathryn E. Holt","orcid":"0000-0003-3949-2471","position":13,"is_corresponding":false},{"id":50975,"name":"Gordon Dougan","orcid":"0000-0003-0022-965X","position":14,"is_corresponding":false},{"id":345187,"name":"Samuel Kariuki","orcid":"0000-0003-3209-9503","position":0,"is_corresponding":true}],"reference_count":82,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T23:44:08.368845Z","pmid":"34515028","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}