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[Correspondence] Madagascar should introduce typhoid conjugate vaccines now

In December, 2017, WHO prequalified a typhoid conjugate vaccine, recommending its use in people aged 6 months to 45 years residing in typhoid fever-endemic areas.1 Typhoid conjugate vaccines have also been included in the portfolio of subsidised vaccines managed by Gavi, The Vaccine Alliance.2 Typhoid fever surveillance has been done in Madagascar since 2011 as part of the Typhoid Fever Surveillance in Africa Program (TSAP) and the Febrile Illnesses Surveillance in Africa Program. TSAP identified an incidence of 171 per 100 000 individuals aged 5–14 years in a rural setting,3 corresponding to five typhoid cases in a study population of 13 188 individuals.

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