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Life sciences · Journal article
Bulletin of the World Health Organization · October 1, 2026
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Enteric fever remains a preventable yet persistent public health challenge in many low-and middle-income countries, particularly in the African and South-East Asia regions. 1 The disease caused by Salmonella enterica serovars Typhi and Paratyphi disproportionately affects children, adolescents and young adults, with an estimated global burden of over 14 million cases and nearly 136 000 deaths annually.1 India carries a substantial proportion of this burden.Hospital-based surveillance in India reports incidence ranging from 12 to 1622 cases per 100 000 childyears among children and 108 to 970 cases per 100 000 person-years among people older than 15 years, highlighting both high burden and substantial uncertainty in measurement.2 Despite advances in treatment, vaccination and surveillance, progress towards accurate, accessible diagnostics for enteric fever remains limited.3 Accurate diagnosis is essential for controlling infectious disease, yet the link between poor diagnostics and antimicrobial resistance remains underappreciated.False-positives lead to unnecessary antibiotic exposure, while false-negatives delay appropriate treatment and encourage the use of broader-spectrum antibiotics without microbiological confirmation.Both scenarios drive drug resistance.This problem is especially acute for enteric fever in endemic settings, where its clinical presentation overlaps with malaria, dengue, scrub typhus, chikungunya, leptospirosis and other viral fevers.Poor diagnostics affect patient care and weaken surveillance by hindering accurate assessment of disease burden and transmission patterns, compromising vaccine A case for eliminating Widal testing for enteric fever, India