Abstract

Typhoid fever remains a major public health challenge in Uganda, particularly in communities where sanitation, 
water quality, and healthcare access are inadequate. Despite the availability of effective vaccines and antibiotics, 
disparities in healthcare infrastructure and resource allocation between rural and urban areas continue to influence 
disease outcomes and economic burdens. This review examines the comparative cost-effectiveness of typhoid 
vaccination versus treatment in rural and urban Ugandan healthcare settings. It explores the economic implications 
of preventive immunization programs relative to the costs associated with diagnosis, hospitalization, and 
antimicrobial therapy. The review highlights how variations in healthcare infrastructure, disease burden, and access 
to vaccination services affect overall cost-efficiency. Findings suggest that vaccination is a more cost-effective and 
sustainable intervention, especially in rural areas with limited access to timely treatment. Policy recommendations 
emphasize integrating typhoid vaccination into Uganda’s Expanded Programme on Immunization (EPI) and 
strengthening health systems to reduce disease incidence and associated economic losses.