The global burden of typhoid fever.
The global burden of typhoid fever.
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DOI：
10.1590/s0042-96862004000500008
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发表时间：
2004-05
影响因子：
11.1
通讯作者：
J. Crump;S. Luby;E. Mintz
中科院分区：
文献类型：
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作者：
J. Crump;S. Luby;E. Mintz
目的利用新数据对伤寒的全球负担进行修订估计，准确了解伤寒的全球负担对于指导疾病控制和预防工作的公共卫生决策是必要的。方法通过计算机检索多语种科学文献，寻找伤寒病例血培养确认的人群研究。如果没有合格的研究，则从邻国和区域推断数据。使用年龄-发病率曲线对狭窄年龄组与一般人群之间的发病率进行建模。进行了单向敏感度分析，以探索估计对假设的敏感度。副伤寒的负担是通过比例法得出的。结果共确定了22项合格的研究。伤寒高发地区（>100/100，000例/年）包括南亚和东南亚。中等发病率（10-100/100，000例/年）的地区包括亚洲其他地区、非洲、拉丁美洲和加勒比以及大洋洲，澳大利亚和新西兰除外。欧洲、北美和其他发达国家的伤寒发病率较低（<10/100，000例/年）。我们估计，伤寒在2000年造成21 650 974人患病，216 510人死亡，副伤寒造成5 412 744人患病。结论新的数据和对伤寒流行病学的进一步了解使我们能够改进全球伤寒负担的估计，这仍然是相当大的。需要在选定的国家和区域，特别是非洲进行更详细的发病率研究，以进一步改进估计数。
OBJECTIVE To use new data to make a revised estimate of the global burden of typhoid fever, an accurate understanding of which is necessary to guide public health decisions for disease control and prevention efforts. METHODS Population-based studies using confirmation by blood culture of typhoid fever cases were sought by computer search of the multilingual scientific literature. Where there were no eligible studies, data were extrapolated from neighbouring countries and regions. Age-incidence curves were used to model rates measured among narrow age cohorts to the general population. One-way sensitivity analysis was performed to explore the sensitivity of the estimate to the assumptions. The burden of paratyphoid fever was derived by a proportional method. FINDINGS A total of 22 eligible studies were identified. Regions with high incidence of typhoid fever (>100/100,000 cases/year) include south-central Asia and south-eastAsia. Regions of medium incidence (10-100/100,000 cases/year) include the rest of Asia, Africa, Latin America and the Caribbean, and Oceania, except for Australia and New Zealand. Europe, North America, and the rest of the developed world have low incidence of typhoid fever (<10/100,000 cases/year). We estimate that typhoid fever caused 21,650,974 illnesses and 216,510 deaths during 2000 and that paratyphoid fever caused 5,412,744 illnesses. CONCLUSION New data and improved understanding of typhoid fever epidemiology enabled us to refine the global typhoid burden estimate, which remains considerable. More detailed incidence studies in selected countries and regions, particularly Africa, are needed to further improve the estimate.