TL;DR: This proposal advocates using cost-effective bacteriophage surveillance to detect typhoid hotspots in water sources. By studying diverse communities in Plateau State, the research aims to correlate phage prevalence with typhoid burden, focusing on areas with varying population densities. The study is essential for targeted public health interventions in regions with limited access to clean water and sanitation facilities. This project is part of my undergraduate student's project. 

I would like your views to strengthen the idea and make the study much more robust to make maximum impact. 

Introduction: 

Typhoid fever is a global health concern, predominantly affecting low- and middle-income countries with limited access to clean water and sanitation. With approximately 11 million reported cases annually, it leads to over 100,000 fatalities. The emergence of drug-resistant strains of Salmonella typhi intensifies the need for new strategies to combat the spread of this disease. We propose using bacteriophages, viruses that target bacteria, as a cost-effective tool for identifying typhoid hotspots in surface waters.

Historically, the utilization of routine typhoid fever vaccination has been quite restricted, even in regions where the disease is prevalent. Recently, the World Health Organization (WHO) has recommended the incorporation of typhoid conjugate vaccines (TCV) in countries facing the highest incidence of typhoid or a significant presence of antimicrobial-resistant S. typhi. However, the inadequate availability of data concerning the burden of typhoid fever in many at-risk nations presents a significant obstacle to the inclusion of TCV in national immunization initiatives.

Prior research has demonstrated the value of environmental surveillance in identifying areas with a high risk of enteric fever transmission. Although it is well known that contaminated water plays a significant role in typhoid transmission, identifying the causative organisms, particularly S. typhi, has proven difficult when using traditional culture methods on water and other environmental samples 

Research Focus: 

This study aims to detect Salmonella Typhi bacteriophages (phages) in diverse Plateau State communities, focusing on areas with varying typhoid incidence and population densities. We will investigate the relationship between phage prevalence and typhoid burden, considering abiotic factors and human-animal interactions with water sources.

Significance:

1. Public Health Impact: Identifying typhoid hotspots is vital for targeted interventions, potentially saving lives and reducing the disease's burden.
2. Antimicrobial Resistance: In the face of drug-resistant strains, this research contributes to combating antimicrobial resistance by pinpointing areas at risk.
3. Data Scarcity: This study bridges the data gap on typhoid hotspots in at-risk regions, aiding public health efforts.
4. Global Alignment: The study aligns with global health initiatives, emphasizing its importance in combating typhoid fever.

Methodology:

1. Sample Collection:  We plan to collect 165 water samples from rivers, tap water, and wells in the North, Central, and South Plateau Senatorial Zones.
2. Data Collection: We also plan to collect Abiotic factors, water pH, temperature, sewage pipes, open drain water, and human-animal interactions documented.
3. Sample Collection and Filtrate Preparation: Water samples shall be filtered and stored for phage detection.
4. Bacteriophage Isolation: Using a cost-effective method involving bacteriophage screening.
5. Data Analysis: Phage titers and abiotic factors shall be analyzed.

Tractability:

• Cost-Effective Technology: This study employs a cost-effective method for detecting bacteriophages, accessible to a wide range of communities.
• Scientific Advancements: Recent advances in bacteriophage research and genomic sequencing enhance the approach's practicality.
• Data Collection and Analysis: The methodology can be readily replicated in similar settings, enhancing tractability.
• Public Health Interventions: Identifying Typhoid Fever hotspots can have a direct impact on reducing the prevalence of typhoid fever in high-risk areas.

Neglectedness:

• Limited Research: Limited focus on phage-based surveillance in typhoid-endemic regions highlights the neglected aspect of this issue.
• Public Health Priorities: Typhoid fever competes for resources with other diseases, leading to its under-prioritization.
• Understudied Areas: Many typhoid-endemic regions, especially in low- and middle-income countries, lack comprehensive environmental surveillance studies.

Conclusion: This research addresses the critical issue of identifying typhoid hotspots using cost-effective bacteriophage surveillance, presenting an innovative solution for global catastrophic risk reduction and pandemic preparedness in the context of typhoid fever. We hope to share the results as they come in. We are seeking ways to make for maximum impact so feel free to make comments to strengthen this.