CHENNAI: Tamil Nadu is among the key contributors to India's mounting economic toll from typhoid fever, with high out-of-pocket spending and rising antibiotic resistance deepening the strain on households, a study published in The Lancet Regional Health – Southeast Asia has found.
The study estimates the national economic burden of typhoid at Rs 1.23 lakh crore in 2023, with Tamil Nadu featuring among five States that together account for over half of the total cost.
A striking finding is the extent of household spending, with families bearing nearly 91 per cent of treatment costs, largely due to reliance on private healthcare.
Nearly 91 per cent of typhoid treatment costs are borne by households, pointing to a substantial financial strain driven by antibiotic resistance,Dr P Praveen Kumar Reddy, Consultant, General Medicine, in a private hospital.
"We are seeing more severe cases and higher hospitalisation rates, particularly among children aged five to nine, as first-line antibiotics become less effective," he told DT Next.
He said resistance to commonly used drugs, especially fluoroquinolones, is complicating treatment. "In several cases, conventional therapies fail, leading to prolonged illness, longer hospital stays and the need for higher-generation antibiotics, which significantly increases costs for patients," he added.
The study identifies antimicrobial resistance as a key driver, with fluoroquinolone-resistant infections accounting for 87 per cent of the overall economic burden. Children below 10 years contribute more than half of the total impact, underscoring the vulnerability of younger age groups.
It also estimates that around 70,000 families across India faced catastrophic health expenditure due to typhoid, highlighting the financial risks associated with the disease. Public health spending accounts for only a small share of total costs.
The findings strengthen the case for early introduction of the typhoid conjugate vaccine under the national immunisation programme, alongside tighter antibiotic stewardship and improved access to diagnostics.
With high-burden States such as Tamil Nadu at the centre of the challenge, targeted preventive strategies and reduced reliance on out-of-pocket care will be critical to easing both the health and financial impact of the disease.