Surgical Complications of Typhoid Fever: First National Typhoid Conference in Niamey, Niger

Typhoid intestinal perforation (TIP) is a life-threatening, late complication of typhoid fever that disproportionately impacts children in low resource settings and continues to have devastating consequences worldwide. Despite elimination of typhoid fever in most high income countries, typhoid fever and TIP remain endemic in many countries around the world as a result of inadequate investments in water, sanitation, and hygiene (WASH) and lack of access to vaccines. A first National Typhoid Conference was held in Niamey, Niger on July 22, 2023, where surgeons and other medical and health professionals from Niger convened with local and international health professionals to discuss their experiences with TIP and advocate for better prevention and treatment of the disease. The high number of intestinal perforations diagnosed during surgery, and the lack of capacity for performing blood cultures motivated surgeons in Niger to convene and share data on complications of typhoid, epidemiology, and diagnosis. TIP, a leading cause of peritonitis in Africa, often results in emergency surgery and has reported mortality rates up to 30% in pediatric patients. The availability of four safe and effective typhoid conjugate vaccines, two with committed financial support from Gavi, the Vaccine Alliance, makes prevention through vaccination a realistic near-option for typhoid fever to complement improvements in WASH.