Table 1.
Baseline characteristics of all communes and those with at least one case of typhoid fever.
Fig 1.
The annual and seasonal distribution of typhoid fever cases at Angkor Hospital for Children in Cambodia.
a) The annual number of culture confirmed (solid line) and non-confirmed (broken line) typhoid cases at AHC from 2007 to 2014. b) The annual number of total admissions at AHC from 2007 to 2014. c) The mean monthly count of typhoid cases aggregated from 2007 to 2014. d) The average monthly rainfall (mm) per month over the study period.
Fig 2.
The spatial distribution of typhoid fever cases in Siem Reap province, Cambodia.
a) North oriented map of Cambodia, the black cross shows the location of AHC. b) Map showing the population density (people/km2, color-coding in key) of the 78 communes within the typhoid study area. AHC is shown by the black cross, the black border denotes Siem Reap province and the left and right asterisks are mark the locations of the communes with highest incidence of typhoid fever; Kaoh Chiveang and Kampong Kleang, respectively. c) Map of the study area showing the rate of reported typhoid cases per 1,000 population under the age of 15 years (color-coding in key). d) Map of the study area showing significant spatiotemporal clusters of typhoid during the study period, the size of the grey circles corresponds to the radius of the cluster and the years of the clusters are denoted.
Fig 3.
The phylogenetic structure of the H58 lineage of Cambodian Salmonella Typhi.
a) Maximum likelihood phylogenetic tree of the 203 H58 isolates identified during this project (scale bar denotes SNP differences). The sub-lineages are shown on the major branches. Isolates exhibiting a multi-drug resistance (MDR) phenotype are indicated by black nodes. The tree is midpoint-rooted for the purpose of clarity. Bootstrap values >85% are indicated by an asterisk. b) Minimum spanning tree subdividing H58 lineage III and IV into the various sublineages (IIIa, IIIb, IIIc, IV, IVa, IVb, IVc). The various sublineages are color-coded for reference and the number of each variant is indicated by the cluster size. The number on each of the branches signifies the number of SNPs between each cluster.
Fig 4.
The spatiotemporal distribution of the various Salmonella Typhi lineages/sublineages in Siem Reap province, Cambodia.
a) Bar chart shows the annual distribution of the various S. Typhi lineages/sublineages from 2007 to 2012; sublineages are color-coded as in Fig 3b. b) Maps showing significant spatiotemporal clusters identified for sublineages IIIc, IV, IVb and IVc. The timing of each cluster is shown by the year in black text and the dotted circle represents the radius of the detected cluster. Background colors represent the rate of each sublineage per 1,000 population aged under 15 years. The incidence rates vary between sublineages, ranging from 0 to a maximum of 0.8 (IIIc), 3.12 (IV), 2.56 (IVb) and 5.84 (IVc) 5.84 cases/1,000 population aged under 15 years.
Table 2.
Regression results highlighting factors associated with typhoid cases.