Published in PLOS One on 2026-06-10, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Jean-Louis Koulidiati, Robert L. Zoma, Eric I. Nebié, Soumaila Yameogo, Christelle Neya Ouedraogo, Joël Arthur Kiendrébéogo, Frédéric Debellut
Source: PLOS One • DOI 10.1371/journal.pone.0351148
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
In Burkina Faso, typhoid fever remains a major public health concern, particularly among children under 15. In January 2025, a nationwide campaign introduced the typhoid conjugate vaccine targeting children aged 9 months to 14 years. This study aimed to estimate the cost of typhoid conjugate vaccine delivery during the national campaign and to identify the main cost drivers across different administrative levels.
We conducted a retrospective cross-sectional costing study using a microcosting approach from the perspective of the Ministry of Health. We collected data from fifty health facilities, eight health districts, five health regions, and the national level. Financial and economic costs were estimated for each level, excluding vaccine and syringe costs. All costs were converted to 2024 USD using the official exchange rate. Parameter uncertainty was explored through one-way sensitivity analysis on key assumptions.
Vaccinators administered a total of 10.5 million typhoid conjugate vaccine doses. The average financial cost per dose was $0.47 (95% CI: $0.39–$0.51), and the economic cost was $2.16 (95% CI: $1.71–$2.56). Human resources and per diem payments were the main contributors to costs. Costs varied by geography, delivery strategy, and security context, with higher costs observed in rural and conflict-affected areas. The mobile–temporary posts strategy had the highest economic cost per dose ($2.02; 95% CI: $1.64–$2.40), while the fixed strategy had the highest financial cost per dose ($0.41; 95% CI: ($0.32–$0.49). Sensitivity analyses indicated robust cost estimates, with volunteer time valuation having the greatest influence.
The financial cost per dose remained within Gavi’s operational support range. The observed cost variations highlight the need for targeted funding and enhanced logistical support to ensure equitable access, particularly in rural and insecure areas. This study provides evidence to inform future vaccination campaigns and supports decision-making for typhoid conjugate vaccine introduction in other countries in the region.
Introduction
Typhoid fever remains a significant public health challenge globally, with more than 7 million cases and 93,000 deaths estimated in 2021 [1]. The burden of disease is disproportionately high in South Asia and sub-Saharan Africa, where poor sanitation and lack of access to clean water—main transmission routes of the disease—are common [2]. In sub-Saharan Africa, more than three million infections and 33,000 deaths occur annually, with incidence rates reaching up to 383 cases per 100,000 person-years in some countries [3,4]. The region has also seen an increase in typhoid outbreaks, such as the 2023 outbreak in the Democratic Republic of Congo that recorded nearly 1,200 suspected cases, with typhoid intestinal perforations occurring in 3.7% of cases [5].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Jean-Louis Koulidiati, Robert L. Zoma, Eric I. Nebié, Soumaila Yameogo, Christelle Neya Ouedraogo, Joël Arthur Kiendrébéogo, Frédéric Debellut. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: The cost and cost drivers of delivering COVID-19 vaccines in low- and middle-income countries: a bottom-up costing study of rollouts in seven countries
- Evidence brief: Prevalence, spatial patterns and determinants of zero-dose vaccination among children aged 12–23 months in Sub-Saharan Africa: A multilevel spatial analysis
- Evidence brief: Concurrent coverage and determinants of vitamin A supplementation and deworming among children aged 12–59 months in 15 Sub-Saharan African countries
